As a professional I’d basically be required to say the above, but I’m also watching from the inside as my country’s health system decays starting with populations that were underserved to begin with like the mentally ill. In other news I have a hospice interview tomorrow. If nothing else I’ll just get to focus on making people comfortable. That sounds so relaxing. I’m getting tired of having to tell people no all the time.

I’m surprised that particular aspect of the side effect profile comes into play with acute usage.

Well obvs. It’s basically,“idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later.”

Ah, yes, this happens a lot. No, I don’t work in the medical field at all. I just know things, for reasons.

Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn’t heard of it, and I’m hopeful, but after seeing abilify get approved for acute agitation I’m… skeptical.

i.e. the psychosis has done so much cumulative damage at this point that you need to fall back to the typicals. That explains why the third-gens are useless.

Yeah a lot of people don’t realize the damage is additive, both people w/ these disorders and unrelated laypeople who think “talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils” is a cool story.

I’m mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you’re trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I’ve actually never seen it used and while I can’t tell you why for certain, I do have a guess.

If you have a patient sick enough that you’re considering an LAI, you don’t want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I’ve had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it’s less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.

Dude sometimes we still give thorazine. And tbh ime the 3rd gens don’t do shit for my typical patient. For context also though, I’m essentially providing ICU level care, so when you say the word “symptom control” it’s often referring to like, fists.

We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I’ve actually seen quite a few pregnancy delusions and they’re almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn’t take it anymore she would just come scream at me for the thorazine.

I’m unsure if you don’t work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that’s flush with people stuck in a cycle of drugs / homelessness so I’m also not going to tell you that any of this is the best solution, just that it’s the only one avaliable to any of us right now due to shitty government policies.

To the extent that men can lactate! It’s one of the possible side effects of risperdal, which I have to be aware of because I give it fairly regularly. It’s all the same structures it’s just a matter of the hormone signals they’re getting.

an oldie but goodie

Nah. Weirdly enough it was the character with the arthropod features I was investigating the concept for but now I wonder if I should’ve done that for the illithid so I might look into that. It was relevant to the other character because the actual arthropod features (wings) are missing by the time of the story so it was going to be one of the “hints” that they had her labeled as the wrong species but first of all it just didn’t fit creatively, it was much too overt to the extent it didn’t even make logical sense for the mixup to happen but also as you see here the science doesn’t follow either it’s only spiders and the like that have it, not dragonflies.

I knew about the hemocyanin because I was trying to figure out if one of the characters in my tentacle porn should have blue blood but decided against it. Cool to learn about the others too though.

You know this is the recommended stance when deescalating violent psych patient because it keeps your hands visible (as in, not hiding something) and in front of your body / face in case they start swinging. I’ve never really felt comfortable doing it though and this kind of explains a possible reason why. I actually had a guy the other night who asked why everyone else was scared of him and I didn’t seem to be. There were probably a couple other reasons though (I’ve dealt with waaay wilder men, and also he mostly struck me as young, dumb, and loud, and dumb in the young sense not in the cognitively not there sense). But as far as this pose idk it just always seemed really patronizing to me. I usually stand more like One of these where at least one hand is on the neck or side of the head. Usually with my hands overlapping but my fingers not intertwined so they’re easy to separate and throw up in front of my face but not overtly defensive.

THANK YOU.

It’s not gross because he’s not wearing gloves, it’s gross because he probably never washes his hands after digging in his ass all day.

Get your reasons this man is disgusting straight people!

I wrote a similar comment about this exact same situation on another post but from a more healthcare oriented perspective. Specifically that unless you have open cuts / sores on your hands as a healthcare worker, clean but nonsterile gloves do not protect the patient! They are an OSHA requirement in place to protect the worker from exposure to bodily fluids and caustic cleaning chemicals. And for chemo you glove twice.

Sterile gloves, which are used to protect a patient from infection and are used for surgeries and specific types of bedside procedures like urine catheterization, are packed in sealed packages in single pairs and must be applied in a highly specific way by a trained individual, the minimum license usually being an LPN and more often an RN.

Unless that beef patty is acidic enough to burn your hands while preparing it (and if it is I shudder to think what it would do to a stomach) gloves out of a 100-count box ain’t protecting anybody from anything and at their worst are bamboozling people out of washing their damn hands.

It probably doesn’t help that I’m incredibly irreverent of pretty much everything. I got really into western esoteric spirituality this past year (its really been helping me with introspection and integrating my personality in ways that neither secular therapy or my fundie upbringing ever quite fully did on their own) but at the same time I refuse to take any religion seriously, especially not my own.

Anyway someone in a related community got upset at me for having my irreverent attitude because I was “culturally appropriating” tarot cards from PoC and like dude. Look up where that shit is from its Northern Italy where my family is from just two generations ago they were fresh off the boat when the War was starting. You’re appropriating tarot from me. And if you want to get into the specific spiritual / divinatory usage that’s even fucking whiter. The closest you’re gonna get to claiming cultural appropriation is if you go all the way back before the tarot to the mummy dust the hermetic order of the golden dawn were probably mixing into the coke they were snorting while making that shit the fuck up based on their judeo-christian / classical mythology crossover fanfiction.

People just wanna be mad about shit and at this point I really don’t have the energy to spend appeasing people who have already decided to be mad at me. Imma just be over here using these cards to let my subconscious tell me which level of Maslow’s hierarchy of needs I fucked up this week.

Removal of gendered aspects without any additions.

I’m pretty apathetic to gender in general but I’ve had gender confirming surgery to be NB which I guess technically makes me trans and to be prefectly honest I’ve never felt more judged for it than by the lemmy LGBTQ+ community. The 50y/o southern man that was my nursing supervisor back when I was a new graduate was more respectful of my gender and lived experiences than these people. Honestly the thing they seem to hate most is specifically me expressing apathy for gender; I’ve mentioned that my transness expresses itself by not caring about the whole pronoun thing or needing to have any specific pronouns for myself personally, but that I understand it’s a matter of respect for others and I’ve literally gotten banned for saying that. Like almost exactly that. They’re absolutely hateful bastards for no reason other than that they’re upset and need everybody else to be upset too. I’m lucky I have a handful of supportive people irl because I sure asf wasn’t gonna find it here!

<3

Randal Munroe is still my celebrity crush.

It’s been a minute but iirc she was liberal and female so I think it was good. It wasn’t the highlight of wild shit I did though I’m usually the weirdo wherever I go.

When in Rome do as the Romans do, and I do particularly love making hilariously taboo statements that mirror more conventionally acceptable fallacies. In early college I wrote an abortion focused “Modest Proposal” suggesting that men be forced to donate anatomical gifts (blood, skin, organs, etc) to their progeny to equalize the physical labor of men and women in procreation. The increased gravity of such a gift is balanced by the lower liklihood of its necessity (it might in many cases be harder on the body, but the odds a child will need it are much lower). I came at it from every angle and took each part of the argument to its most exaggeratedly ridiculous extent; Swift would’ve been proud. I’ve since lost the text, however.

Look at men’s bodies! They have prostates capable of being stimulated to climax. God designed men for the magnificent job of bottoming and what could be more beautiful than a man orgasming while getting railed up the ass?

Or you’re night shift and look like death and they just kind of look really guilty while they ramble on for a few minutes before mumbling that you can just go.

I’ve been told I’m annoying and need to shut up as long as I can remember. Probably since I started talking.

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