Apytele

@Apytele@sh.itjust.works

I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

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Apytele,

The message to me was just that sometimes you have to sing and dance to entertain the people who have power over you. That doesn’t make the situation right, but I’ve gotten a lot more done since that realization.

Most Americans with mental health needs don't get treatment, report finds (www.npr.org)

Roughly two-thirds of Americans with a diagnosed mental health condition were unable to access treatment in 2021, though they had health insurance. And only a third of insured people who visited an emergency department or hospital during a mental health crisis, received follow-up care within a month of being discharged....

Apytele, (edited )

I’m an inpatient psych nurse. We do need more facilities and clinicians, but the muuuch bigger issue is affordable housing. I would say about 33% of our unit census at any one time, especially in the winter, often boils down to people staying for what I like to call “3H1C” treatment, or “three hots and a cot.” They’re homeless and come to the Emergency Room and say they’re suicidal (the good ones fake or exaggerate psychosis) so they won’t freeze to death or otherwise die of exposure. I don’t blame the doctors for not taking any chances, and I don’t blame the patients for lying. I also honestly just don’t want to live in a world or work in a system where I have to try and figure out if someone is lying about wanting to die.

Honestly I don’t even really want more homeless shelters; we need to make housing affordable again. We can’t be keeping people in shelters, especially not when they also have mental health concerns, and there’s still a pretty big overlap in those populations. Just because they’re not suicidal and don’t need to be cared for at my very invasive and expensive level of care, doesn’t mean they’re mentally healthy enough to not shank their bunkie because they have PTSD from some kind of institutional or homeless experience. Some of these people jump up out of bed in a full rage if you’re not reeeeaaaallly careful about how you do it, imagine them sleeping in bunk beds! The only way to keep people safely packed in like that is an immense amount of supervision. It’s honestly probably cheaper to just give them more personal space. Many of them will still need significant assistance to safely live independently due to the psychological effects of chronic institutionalization, but coming by once a week to teach them how to cook or do their own laundry is a much cheaper, less invasive, and more humanizing approach.

Edits: sorry I just keep adding shit and fine tuning I’m way too ADD.

Apytele,

Take pictures of yourself; it will help illustrate the point much better. You could also make them a short video or pay for stock photos. Most stock photography is in one of a few very specific styles because they best show objects and actions, so they should be relatively visually consistent but you could also use gimp to help keep the colors consistent. Gimp does also have some cartoon filters, but they take a lot of editing to look good. Might still be easier than trying to draw it yourself or commission something.

Apytele,

yes in that it’s a diuretic, no in that it’s not actually good for your kidneys. But now that you mention it…

Apytele,

Oh, bless! I wish you as much health as you can get!

Apytele,

bruh you need to train more on the pushups and pullups and spend less time in your routine on practicing fuck ups!

  • sincerely, fake gym bro
Apytele,

…huh. thank you for sharing.

Apytele,

Unironically what I learned from DBT. “If you want people to be impressed with you, think up something really impressive that you could do and go do that.”

Apytele, (edited )

I feel like whether this is true or not, the fact that all these words are starting to show up together again means that we’re probably about to all start killing each other again. Edit: well, we already have. But like a lot again. Like idk if there’s gonna be any people left, a lot. Humans have been shown to be pretty tenacious, so I’m really hoping this is just part of the process. But it seems like every time we do this it’s so much more widespread and so many more people die. I just wish everybody would stop caring about who’s wrong and who’s right and just breathe and ask themselves how we’re going to get out of the next few decades with the least people dead before their time.

Apytele,

I used treats to show her I like it when she boops my nose with her nose. Now she just does it when I slow blink at her and she comes over and boops my snoot then I take a single finger and gently stroke her cheeks. Then she just loafs on my chest and purrs.

Apytele,

This took me a few months and I’m fairly skilled at both training animals and working with people to change complex behavior patterns. So this is gonna be heavy on the behaviorism side and somewhat show how little I know about cats in particular. Repeat each step a couple times. if you have trouble with a step, try going back to the previous step and repeat it a few times again.

  1. Make sure the cat knows how to take treats out of your fingertips safely. This is a trick that is actually usually easier to teach an older animal because it requires patience. Start a fun new game where you literally just give them treats from your fingers for doing nothing and the only rule is to not hurt you. Give them up to a normal maximum of maybe 5 in a row depending on the size of the treat. But if they get too excited and hurt you trying to get the treat, yell OW and stop immediately, AND do everything to prevent them from eating the treat you just offered. Eventually they will learn to walk up calmly and gently take it. This is very helpful considering you are about to put the treat near your face.
  2. Give cat treat near your face
  3. Give cat treat in front or your nose.
  4. Swap the treat for your nose at the last second and boop their nose with your nose.
  5. Decide on a word or sound to correspond to their nose touching your nose. I make a noise somewhere between clicking my tongue and kissy noies.
  6. Stop using the treat to directly lead them into the motion and just hold it off to the side so they know it’s there, but instead try to get them to boop your nose just by using your verbal signal.
  7. Hide the treat, but still give it for a successful snoot boop.

Quality Control Moment! It was important to me to get a good firm snoot boop, or no treat. This communicated to the cat that I did really want a full snoot boop, not just face proximity. So I didn’t reward snoot boops I wasn’t sure I felt. Almost always with people and animals you’ll get whatever behavior out of them that you reward (although sometimes with both people and animals it can sometimes be difficult to tell exactly what they’re getting out of it, but I digress), so if there’s a way you do NOT want to be snoot booped, this is the part where you communicate that to the cat. Do not give treats for snoot boops you do not enjoy.

  1. Introduce intermittent reward to fully solidify the behavior. This isn’t actually about your comfort, intermittent rewards are actually more powerful than consistent one (it’s one of the key things that makes negative consequences so hard to successfully implement; any inconsistency is just a highly powerful reward). I usually start with every other, but if you have a particularly clever or stubborn cat you could even skip only every third or fourth treat at first. You then wanna move from there to every other, then start giving a treat only every third time and so on. You’ll never taper the animal all the way off the reward, but you can definitely get it much closer to a “when I feel like it” schedule.

These last two are just cuteness fluff on top of the core trick.

  1. Cross-taper the command into a slow blink. Do this by doing the command and the slow blink one after the other, or by using a verbal command to get the animal’s attention, then utilize the slow blink. After a while, try the slow blink alone. If it’s not working to back to strengthening the behavior, maybe by increasing the treats at least for a bit.

For this last one it’s ideal to have a cat that really likes attention from humans. The more of a human attention whore they are the less repetitions you will need since they will be excited to get pets in place of food. It helps for the other steps to have a cat that is comfortable with humans, but anyone can be a ho for treats. To accept love as payment you have to actually like the person.

  1. Transition from treats to pets. You should already be intermittently rewarding. Keep giving the same amount of treats, but occasionally pet them in their very favorite bestest scritches spot. The one that makes them go bonkers. It’s usually on the head or neck, or somewhere on the spine. My cats is her cheeks, as stated. If they’re a super human attention ho cat sometimes you can even give less treats or even just discontinue giving treats entirely.

Now my cat is like "damn all you wanted was snoot boops and I could’ve been getting prime cheek rubs this whole time???

Translating across entirely different types of cognition (as between separate species) is exhausting.

Apytele,

You made the mistake of getting me to talk about something I love teaching. The cool part, to me, isn’t that it works with dogs too, it’s that it also works with people. The only difference is people, for the most part, get to decide what they want to be trained to do. Cats and dogs tend to react more directly to the environment. This is a pretty critical part of DBT Theory which is one of the core theories I use whether I’m dealing with a substance use patient or some one who’s chronically self-injurious.

Behavioral Chain Analysis is also pretty cool and fun! It doesn’t even have to be about anything serious. The example given in the class I took was “I want to remember to drink more water,” and the easiest link to break in the chain (iirc) turned out to be proximity to the water, so the solution was to keep the water bottle at the work desk. Here’s a good worksheet if you ever wanna try it but need a good way to write it down.

Apytele,

Things didn’t work out with Angela apparently.

Apytele,

B-E-A-U-tiful

Apytele,

Ok legit though Jenna Marbles was a YouTuber spitting straight facts at me in highschool such as where the tiddies go in competitive swimsuits (into warpspace as competitive suits are designed for), hating other women for random shit is functionally useless and actively harmful, and knowing how to dress up AND be a weird feral goblin thing are not mutually exclusive wisdoms. I’m really hoping she didn’t start doing some nonsense to ruin all that because damn those were some positive messages I needed to hear when I was younger.

Apytele, (edited )

I’m with you on this. When the cops show up everyone should be at least slightly relieved. Your immediate thought should be,“Oh thank goodness somebody is here who knows what to do and is gonna make sure we’re all safe.” Tbh I think they need to be reformed and subsequently regulated the way doctors and nurses are. In fact, I suspect lawyers may actually be regulated similarly and could perhaps form an even better basis for licensure and regulation than I’m explaining here, but police do share a responsibility for people’s immediate physical safety in a similar way to doctors and nurses.

We have codes of ethics as to how we’re supposed to prioritize the end goals of the situations we’re expected to resolve. For cops it could be something like (in order):

  1. All humans exit the situation with as little physical and psychological harm as possible, and with all legal rights preserved. (Animals too, but obviously humans would take priority).
  2. All evidence and documentation of the situation is collected and preserved as faithfully as possible in the event of judicial proceedings.
  3. Preserve property and ensure it stays with or can be returned in a timely manner to the rightful owner. (Right now it’s 3-1-2 and often they don’t care who the rightful owner is.)

We have rigorous schooling (and accreditation processes for those schools to try to keep them up to standard) that teach all of the above plus the details they need to know how to uphold those standards. In particular I would like them to know:

  1. Legal aspects of enforcing the law including the basics of what is and is not illegal for both them and others to do.
  2. To what extent they need to intervene with each violation and at what points people begin losing rights (when you’re hitting someone you can be physically held and detained to prevent you from continuing to hit people).
  3. How to preserve evidence (then terrify them with the legal ramifications for not doing so properly).
  4. Basic body mechanics as they pertain to physical and mechanical restraint and seclusion (I’m a psych nurse and have been restraint trained for 7 years now. It’s been drilled into me all through that time to never ever in forever restrain someone face down. I looked into it and even cops are supposed to only have someone facedown long enough to get them cuffed, then immediately turn them on their side. Facedown restraint is one of the easiest ways to even accidentally kill someone, and if that’s been properly taught to you toy can barely call the act accidental anymore.).
  5. basic psychology including a broad overview of both developmental and abnormal psych, including psychosis, mania, anxiety disorders (including PTSD) autism, intellectual disability, and personality disorders. Particularly things like the paranoia that’s characteristic of psychosis, and that yelling at ppl with autism is not likely to produce any favorable result.
  6. Smaller localities could accept lower levels of education or licensure to accommodate the difficulty of obtaining staff for more remote or less funded departments provided they still have the recommended number of staff with higher licenses supervising and intervening as needed (ex: Many heathcare entities utilize CNAs and LPNs to assist RNs provided what they are doing is within their reduced scope and monitored appropriately. An example could be allowing the lower level license to be the second officer provided the other officer they are accompanying does have whatever is decided on as the necessary licensure, or that that person is on duty in a more central location to be called out as needed).

**Regulatory oversight boards that:

  1. Accredit the educational programs
  2. Administer licensure exams
  3. Issue licenses
  4. Review complaints against people’s licenses
  5. Revoke or restrict licenses as needed
  6. Pursue people legally for fraudulently claiming to have a license or a higher or less restricted license than they do

Personally paid malpractice that:

  1. Pays for an attorney to defend this person’s if they are facing board or other legal action
  2. Becomes progressively more prohibitively costly for the individual if they are found to be abusive or negligent
Apytele, (edited )

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Apytele, (edited )

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is sit/stay a mean trick to teach a cat?

i want a little buddy not an obedient kitten. I wanna have conversations with my cat through our actions not tell him to do everything i say. I would love for him to think for himself and learn. but hes sooo stupid guys i know he’s young (a year and 8 months i believe) but im also not speaking his language. he’s smart im...

Apytele, (edited )

Part of loving your cat for who they are is understanding his wants and needs and how his cognitive level factors into him meeting them. It also sounds like you need to better understand the type of stimulation he needs to be happy. Cats are often food motivated, but they also need to chase and murder things (even if they’re not actually alive) and scratch and feel their tendons in their arms stretch (serves multiple functions ultimately but that’s the stimulation they need). They need those things the same way people need to sing and dance and make and view art and tell and listen to stories. They don’t do it to be good at it they just kinda… gotta. If they don’t get to do enough of that they will go a little stir crazy.

Personally I prefer a cat OR dog to jump away from something if I tell them to, and I will move them somewhere less stimulating or even spray the cat with water if they don’t. From my perspective it’s my job to keep them safe and if they’re trying to get at something that’s going to hurt them like chewing on an electrical wire or trying to eat something toxic I need them to stop right away, not five seconds later when I make it across the room and they’re already hurt or going to be very sick. And I need to be able to teach them not to do it even when I’m not looking (but like I said the biggest trick to that is making sure there’s other stimulating things that are WAY BETTER anyway).

Apytele, (edited )

Honest answer?

Short term either DKA (Diabetic Ketoacidosis) or HHNS (Hyperglycaemic Hyperosmolar Non-ketotic Syndrome) both of which will put you in a coma in the ICU, and HHNS is more common in type II and puts DKA’s sugar readings to shame. I’ve seen photos of glucometers from ICU nurses with an error message that just says “HI” as in, this shit so wild the meter can’t read it.

The long term complications are both waaay worse and waaay more likely.

You can’t give glucose (sugar) through a peripheral (arm) IV when somebody’s on IV nutrition because the sugar crystals literally shred smaller veins, and your body not being able to control its own glucose will do the same thing. This is bad because there’s multiple central and far away parts of your body that rely on little veins.

First of all your internal organs rely on capillaries to bring blood to their individual units, no matter what those cells are doing. Kidneys are a common thing to fail, because those tiny capillaries are what feeds each one of their tiny little filter units.

Your kidneys will also see a lot of the sugar because when your sugar goes up your body will panic and start trying to dump it out in your pee. (That’s why uncontrolled diabetic pee looks syrupy, btw, and you might start getting bladder infections now that your pee could put southern us sweet tea to shame). Once your kidneys start failing it will start messing with your blood pressure in addition to the sugar crystals shredding your veins and all of your arteries and veins will start losing elasticity. This makes them more likely to both clog and burst from the pressure, either of which can cause strokes and heart attacks.

Your extremities on the other hand, especially your fingers and toes, rely on those capillaries to bring oxygen, nutrients, and if needed white blood cells to control infections. So the nerves in your fingers and toes will start dying and you’re lucky if they just go numb. Sometimes the nerves just decide that if they can’t feel a signal from a part they should just tell you it hurts all the time. That’s called neuropathy.

The other thing that will happen is your extremities won’t be able to heal wounds, and not only can they not fight off infections (the white cells can’t get through the shredded veins), but now your blood is also sugary and delicious to both bacteria and fungi. You’ll also be too numb/always in pain to even notice if you get a paper cut, stub or cut your toe, or even just get a sore from new shoes. So if you’re not constantly inspecting your toes for tiny cuts, by the time you even notice an injury it’ll be huge and infected. Gangrene and amputations are extremely common in uncontrolled diabetes. I’ve met numerous diabetics with bilateral above-the knee amputations because it got that far before they realized.

By the way, you’ll start having to pay for a podiatrist, like, a licensed medical doctor, just to cut your toenails. They’ll have to inspect every new pair of shoes you buy too since a sore on your heel can threaten your life now.

Even if you’re constantly inspecting your feet, eventually the blood supply will be so bad that the cells in your fingers and toes won’t be able to keep up and you just get sores anyway, and they’ll almost definitely get infected as described above.

Also, to cap this all off, you’re also gonna go blind. Those glucose molecules are also going to shred your retinas. Diabetes, being high blood sugar, affects everywhere the blood goes.

And because your body is constantly inflamed by both the infections and being shredded every day, you’ll be at extremely high risk for multiple inflammatory processes, particularly strokes. When my psych unit was briefly used for COVID-psych, I had a diabetic stroke out with 0 warning (oh also don’t catch COVID with uncontrolled diabetes that’s one of the biggest risk factors for it killing you or, more likely, permanently disabling you. I’m sure your parents will be much easier to deal with when they’re making fun of your slurred post-stroke speech).

Be honest, do you still use reddit?

I used to check the front page at least once every day, and occassionally check specific subreddits. Now I don’t look at reddit unless theres some drama, like mods getting purged, then I’d go there and enjoy the drama. Occasionally there will be questions that only reddit has the answer to so I have to reluctantly use it. I...

Apytele, (edited )

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Apytele, (edited )

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