Apytele

Walmart does the same. Pushes out all the local grocers first.

so I looked into this because your comment sparked some curiosity and from what I can tell it’s less about the chemical itself and more about how your brain regulates and uses it. There’s also limited evidence as to whether GABA as a dietary supplement is even crossing the blood-brain barrier (where it would cause these effects). The other thing you need to keep in mind with most “natural” supplements is that the FDA regulates them under the F, not the D! Things like melatonin (which I even take personally) are regulated as FOOD, not DRUGS. Drugs have to be exactly the chemical they say they are in exactly the amounts they say they are per. pill. and as over the counter medications have to have approved safe dosages and frequencies on the packaging and all pills prescription or not have to have a unique alphanumeric imprint on each pill that can be used to identify it if it is separated from its packaging. Even different doses need unique imprints. Food needs to: mostly probably be the thing it says it is. If it’s a plant it might be a different strain between different manufacturers. that plant also might have a variety of other chemical structures in it that aren’t advertised on the bottle. say almost whatever the manufacturer slaps on it in terms of dosage or frequency. have no imprint whatsoever to identify it if it’s not in the original packaging. Like I said I use several supplements myself that even have good evidence behind them in terms of safety and efficacy. But you need to be aware of the ways in which they’re regulated differently than drugs and know that you’re gonna have to do a little more research for yourself to really find what’s going to be safe and effective for you. Finding a physician who’s educated in holistic and integrative therapies can be super helpful for something like this.

no good answer due to normal variations in physiology and variations in the specific person’s quality and severity of addiction but in terms of timescale I would say a day-ish? Would be better to ask an ICU RN or MD. At my level and specialty of care (acute psychiatry) and assuming the pt has been screened appropriately by the ED to not already be in high acuity withdrawal (needs medical or ICU) we’re generally not talking a minutes to a couple hours but we’re also not talking a week. The scale we use to measure is called the Clinical Institute Withdrawal Assessment. Depending on the half-life of the medication used for the taper I’m reassessing that score either every 4 hours (ativan) or every 8 (phenobarb). My unit usually does phenobarb because it requires less frequent and precise assessment due to the elongated half-life. And I can always reassess ahead of schedule and give 1 extra dose as a standing PRN order without even needing to call the on-call MD if they’re having breakthrough symptoms.

tbh I’m not on the research end I’m on the butt end with the people experiencing it directly (which is where I wanna be the most I wanna do is maybe teach someday) so I have empirical backup but most of my knowledge is experiential.

fun fact; drugs that act on your GABA nervous system (benzodiazepines such as xanax, also barbiturates and alcohol) are the only drugs that will kill you outright on withdrawal. Stimulant withdrawal (amphetamines, cocaine, caffeine, nicotine) causes headache, confusion, fatigue, and occasionally suicidal ideation. Opiate withdrawal (oxycodone, heroin, fentanyl), causes anxiety and flu-like symptoms that can be fatal if severe enough (dehydration, GI complications) but, only in the same way that a flu can, and do not kill you outright. (THC / marijuana withdrawal is the chillest, usually only causing mild irritability and appetite loss, which the others do to a much greater extent). Benzo (and other GABA active withdrawals) causes a rebound of your nervous system’s stress and fight or flight system that cascades from: extreme anxiety and most of the same flu-like symptoms as opiates then into vivid hallucinations (often of being covered in insects including tactile sensation) and paranoid delusions, then finally into back-to-back seizures that eventually result in nervous system failure, hypoxia, and death. The old-school word for this is “the delirium tremens” or “DTs.” If you are using these substances at a high enough and especially an unsustainable dose (which can cause respiratory depression / hypoxia and weakness of gait / traumatic head injury, similarly to an opiate overdose) you will need to be withdrawn in a either a specialized rehab with medical capabilities or if the addiction is severe enough a hospital or even specifically an intensive care unit. It’s possible that if you’re a binge drinker (drink large quantities but don’t drink at all some days) you may not need special withdrawal precautions. That said, addicts often minimize the extent of their addiction early in the recovery process so a lot of facilities that are unequipped to manage this type of withdrawal will refuse those patients outright until they’ve been medically evaluated. I’ve actually had a few patients were the ED was like “oh yeah he’s a lil jittery but not actively withdrawing” and a few hours into being on the unit they can barely bring a cup of water to their mouth without spilling it. Obviously the history of legislative bans on alcohol is a great example of why criminalizing substance use is pretty much always a losing battle but it’s also WILD that alcohol is legal when specifically compared to marijuana being illegal. This has been a PSA.

One of my points of pride is actually using my teeth. A light scrape or nibble dramatically increases tactile sensitivity and emotional intensity. If you know how to simultaneously integrate the tongue and lips properly you can really leverage that "crazy girl sex" that drives dudes fucking nuts. I may have had years of therapy but there's a few holdovers just because crazy girls do it better. The other big thing is gregariousness because once you learn to use it *with* real day-to-day support and respect for people it just magnifies it.

One of my coworkers said she loves working with me because she’s not scared of running into problems because I have the solution to 90% of what she runs into. I was like bitch. what. but then I remembered she doesn’t fight me on having to take charge nurse all the time and like. A few weeks ago she got in trouble for something one of the junior nurses didn’t handle quite right (tbh none of us would though that pt should not have been on our unit) and getting in trouble for shit other people do is exactly why I fight like hell not to be charge nurse all like. Just for you. None of you other people. If you’ve ever asked "well why can’t Apy be charge she has the most experience!??!???! Exactly. Y’all stupid and idw be on the hook for your shit. I’d rather just solve the problem on the sidelines and you can take all the credit for whether it works or not (and like 90% of the time it will so 🫅)

One of the interesting things I’ve found while reading through is that while there’s a lot of minor sins mentioned once each in the old testament (like mixed fiber clothing) the one commandment that is mentioned more than any other, like almost word for word with every repeat is keeping the Sabbath. And many of those repeat mentions also specify that it applies to your workers / servants as well. Even if they’re not also Jewish, it’s a sin for you as the Jewish person to not give them their rest day. Idk I just found that super interesting especially in this modern context of modern US Christianity flavored capitalism.

I finally grasped the concept by internally translating it as his/her Highness as in–"does her Highness want more tuna? Her Highness seems like she wants more tuna."

The world would be a better place if people spent more time recognizing admiring skilled labor. Like even people who mostly just move and make things. The level dexterity alone is just 👨‍🍳🤌💋

Honestly both chihuahuas and pugs should also be banned. It’s not their faults we bred them to be sick but we should very much like, stop. At least get all the ones that currently exist fixed. They weren’t inbreeding themselves by choice to begin with either so it’s not like we’re fundamentally removing some choice they had by stopping people from continuing to.

Honestly both chihuahuas and pugs should also be banned. It’s not their faults we bred them to be sick but we should very much like, stop. At least get all the ones that currently exist fixed. They weren’t inbreeding themselves by choice to begin with either so it’s not like we’re fundamentally removing some choice they had by stopping people from continuing to.

Me: “I can’t have caught the family autism gene; my language skills are too good.” Older me: “so apparently hyperlexia is just another autism presentation…”

Now I wanna make an art series of each logo pasted onto the back end of a cat generated by their generative image model.

Broke: the Apocalypse is coming Woke: the Apocalypse has come and gone and come and gone numerous times and in each occurrence replaced our comfortingly benign world with something new and terrifyingly incomprehensible. The crystal temples of revelation have been both built and felled and will be built again and the only assurance we have is that each successive apocalypse and the world that comes after will be be unthinkably more bizarre.

I was gonna say that some of this is also probably sentencing bias. Subjectively the correlation seems too strong to not have some truth to it. I also have other data to support male = higher violence risk largely outside of perceptual bias. As an example from my area of expertise, men complete suicide more often because they typically choose deadlier means (guns especially) vs women are more likely to attempt something like a drug overdose which is more reversible / leaves more opportunity for aborting the attempt. There’s not a lot of room in those stats for perceptual bias, dead is dead and alive is alive. It’s basically a known fact that men are more violent to themselves. I won’t get too much into the stats of violence against others except to say that the statistical predictor tool I’ve used for that in institutional environments didn’t use “male,” it used “male under 30y/o.” On the other end of perceptual errors almost govern criminal sentencing. Entrusting a group of people to judge an event reduces some but not all of the perceptual bias, but certainly can’t eliminate it. And I do also have my own subjective / experiential perspective that suggests what you do. When I first started in my field I was told and found to be true that when you’re breaking up a fight between men all you need to do is break eye contact. You get between them back to back with a coworker and if you can’t block their sightline to each other with your bodies you shove one of them around a corner. And that’s it. Within about 30 seconds they’re in tension reduction talking about their feelings in that emotionally constipated way western men do (“he just made me so mad!”). Otoh I was told and found to be true that you let the women go at it until the entire code team arrives from your surrounding units because you’re going to basically have to do a full restraint episode for each woman.

And there’s a lot of right to repair fights. If you think a Honda trying to lock you out for not taking it to the dealership for an oil change is bad, just imagine how bad it is for somebody with a combine that costs most of that million.

This is my gripe with tankies. One of the most salient points of 1984: “It was now impossible for any human being to prove by documentary evidence that the war with Eurasia had ever happened.” “Oceania was at war with Eurasia: therefore Oceania had always been at war with Eurasia.” All war is fake except the class war.

Honestly I wonder if some of it isn’t people in super remote areas or otherwise disconnected from conventional communities. If you live on a mountain with no internet or TV and drive into town once a month for groceries or live in an underground mole people tunnel system it’s probably easier to not give a fuck. Like obviously these things will still affect you, but not in any immediate way that’s gonna slap you in the face tomorrow.

Or a Presbyterian church service.

Apparently a hospital in my network is trialing a tool to generate assessment flowsheets based on an audio recording of a nurse talking aloud while doing a head to toe assessment. So if they say, you’ve got a little swelling in your legs it’ll mark down bilateral edema under the peripheral vascular section. You have to review before submitting but it seems nice.

Is it still made by a human if they use the stroke smoothing, clone healing, or edge detection tools in photoshop or gimp?

Honestly the research on exactly why this happens is sparse enough as it is. It’s basically impossible to do truly conclusive studies with tobacco because of how dangerous it is. We can’t even technically conclusively say that tobacco causes cancer because to truly scientifically assert that you’d have to do a randomized controlled trial. To have a truly randomized controlled trial you would have to randomly select people from the overall sample and tell them to start smoking for the purposes of the study (otherwise you can’t rule out there being some third thing that both causes the cancer and causes people to want to smoke). And because we know tobacco is insanely addictive and are all but that one millimeter short of proving that it causes cancer, no medical ethics oversight body would ever allow a study that requires participants to start smoking.

Hubs wanted to sell some used household goods but everybody is on Facebook marketplace and using venmo and cashapp and shit these days and I’m just like. And now his friend says he wants to use zelle for me to go halvsies with him on hubs Christmas present. Fucking marks of the beast!

could be SSRIs

It also paralyzes your cilia so it’s not improbable (cilia are the little hairs that line your breathey tubes and rhythmically beat to push gunk up and out). It’s actually why the smokers cough usually gets worse a few days after quitting then stays worse until you’re finished hacking up all the built up tar. Your cilia wake up to your respiratory tract fucking trashed like WHAT THE FUCK IS THIS.

My first thought when I saw this was damn this is freaky and they haven’t even brought in the third sister yet…

I hate that you’re right about the electrolytes.

🤣

Eh. You can get a vibratoring back massager from the home goods section in Walmart for $6.

Legitimately why I picked up tarot reading though. I needed an introspective mindfulness activity. I used to do cognitive behavioral therapy with spreadsheets. It was informative but exhausting. I think it gave me a good set of foundational concepts, but realistically humans are just fundamentally meant to surround themselves with pretty rocks while talking about how much they personally relate to shared culturally inherited stories. And I just love explaining Gnosticism to people in the most chaotic way possible.

I’ve spent my whole adulthood working in hospitals. They’re shitholes, every single last one of them. Do every single thing you can to never be in one. Drink water, plain water. Eat whole grains and leafy vegetables. Treat red meat like a dessert. Find a physical activity you enjoy and do it at least three times a week. Either join an organized religion or specifically curate a group of people you do a weekly activity with who will come check on you if you suddenly stop showing up. And while you’re at it pick a mindfulness activity that you either enjoy or that brings you peace (prayer qualifies but so can yoga or a lot of other things). Avoid nicotine and alcohol at all costs. Go easy on the weed, and avoid anything more interesting without guidance from either a medical professional or some kind of traditional expert on those substances. Decide who you would want to speak for you on your death or near-deathbed. Choose people both trustworthy and level-headed who will put your wishes over their own emotions. Choose multiple people, because it’s not unlikely that any one person will be in the car wreck with you. Talk to those people about what you want to happen or not happen so they can best carry out your wishes. And good luck because while this will give you the best odds, the universe might also just decide to fuck you in particular anyway.

If you wanna log your logs the old fashioned way with just a spreadsheet: Date / time Small / medium / large Bristol Scale color could also add odor or discomfort if you’re worried about that On a second spreadsheet in that workbook, keep a food diary, because that’s gonna provide a LOT of context (and you might discover some ways to be nicer to your tummy.

me too actually!

It is but one of the older versions that eliminated the “eat the whole map” mode that was the best mode.

Hole . io (spaces otherwise it’ll create a link). It’s an ad and transaction ridden garbage game but it’s so satisfying and nothing else in that subgenre has graphics that cute.