Apytele

Apytele, 9 days ago

Oh god I was worried they killed him horribly this is actually probably fine and almost an expected setback.

Apytele, 9 days ago

For a technology that could someday help a quadriplegic interact with the world fully and independently again I’m willing to tolerate some hitches. There’s a reason they didn’t pick some full on walkie talkie for their first human trial, and there’s a reason that kid looked motherucking hyped to have brand new technology that he’s the first human to even try installed directly into his fucking brain. The problem is abled people thinking this is fundamentally for them. Bby no, they’re trying to help people walk again, even if the legs are robots. You’re looking at the wrong risk-benefit profile.

Apytele, 9 days ago

yes, screw the quadriplegics so you can feel good about staying on your moral high ground. Your hill to live and die on takes much higher priority than people who can’t shift their own body weight developing holes in their ass I can fit my fist in but still not be able to see the bone because it’s covered in maggots. Yeah there need to be guardrails in place to keep him from doing silly shit with it and make sure it’s affordable for the people who need it, but a) the technology is still in it’s infancy b) how about you put all this piss and vinegar towards political action to beef up the FDA (who are already regulating this situation per the linked article?). While you’re at it the CDC could use a little more money and public backing too. How about you go out into the world and encourage people to trust scientific institutions more? There are about a thousand different ways you could be expressing these morals in a way that actually helps people instead of just making you feel better about yourself.

Apytele, 9 days ago (edited 5 days ago)

Hi I’m a psych nurse with my own mental health issues so I’ve both had done similar problems and worked with hundreds of other people who have had similar problems.

a) get yourself into one of those alanon groups for family and other loved ones of addicts. They will give far better advice than I or any other internet person ever will.

b) decide on your boundaries now and communicate them clearly at a moment that he’s in a good headspace (don’t just pop it on him right after the wife files for instance).

c) Your personal boundaries are very personal, but I do recommend you decide on how much money you’re willing to give him and how. It could be anything from 1k towards the debt if you’re exceptionally kind and have it to give him, to just offering to buy him a good meal now and then. If you ever help with rent or anything however, I highly recommend you pay the person he owes directly so he doesn’t have a chance to think he can solve all these problems with one more because it’ll finally be his big win.

c) Also decide how much you’re willing to get yelled at because I can almost guarantee he’s going to get frustrated with those boundaries and cuss you out at some point. You don’t have to lay this out in detail but I do recommend you at least say “I do expect to not be abused.” And he’s not going to be joking he’s going to bring up any traumas or mommy issues or whatever skeleton in your closet that he knows about. I know because I’ve done it and watched hundreds of other addicts do it. It’s a normal response to both the internal chemical changes as his neurotransmitters re-level AND all his interpersonal relationships shift to healthier ones. You’re still not obligated to sit through that. So decide how much you’re willing to take now. If your line is physical aggression, decide if you’re willing to put up with him getting in your face without swinging, because a lot of people who have gotten good at being addicts know how to toe lines real good so you better paint them bitches crisp.

d) recommend whatever mental health resources you can talk him into going to. Anything from support groups (AA has a lot of spinoffs for other addictions, but 12 step is usually better for more spiritual people. If he’s particularly secular, try SMART instead). Also definitely encourage him to go to a psychiatrist. Even behavioral/nonchemical addictions can significantly alter brain chemistry in a way he may need a leg up to really overcome (behavioral addictions are things like gambling, binge eating, video games, and porn vs chemical ones like heroin, meth, etc. As an aside, weed is kind of a grey area, it’s not super chemically addictive, but it can definitely be behaviorally so for the wrong person).

e) if you’re really down for it, learn a few formal crisis intervention strategies. You could try taking a mental health first aid class or reading a book but to give you a leg up I’ll tell you the skill that took me 10 minutes to learn and I literally use it every single night I work: S.E.T. communication or Support, Empathy, Truth.

Support - a simple statement that aligns your values and desires with his.

• "I really want you to get this debt handled. I want you to get out of this and stay out of this.
• “I want to stand by you and keep helping you with this.”

Empathy - a simple statement about your understanding of why this has been difficult for them.

• “and man it’s a shitload of of money you’re probably looking at like mount fucking everest.”
• “and I know you’re going through it right now”

Truth - a possibly less simple statement of the best way they can step with you towards that goal. The other two steps are to give you the best possible setup and help him feel heard to get him in just the right headspace to really hear this part.

• “I can’t buy you out of this and honestly I don’t think it would help you in the long run if I did. The best way to get this paid off is to not get into more shit and take what you have now one step at a time.”
• “and I wanna be here for you to lean on through this but I can’t carry you. To keep working with you on this I need you working with me. I’m gonna give us both a day or two to let the steam blow off, and then I’m gonna come back and try to talk this out again so we can get back on the same page.”

It doesn’t work 100% of the time but compared to fumbling your way through these conversations it’s practically magic.

This brings us to f) if he does get hot, DO. NOT. ARGUE. do not argue when people are not capable of responding rationally. It tends to just increase the irrationality and nuke any working relationship that’s been built. He might do great for the most part but every once in a while the dopamine or adrenaline or whatever else is gonna hit just right and he’ll turn into a straight asshole for a short period. Just tell him you’re both gonna take a breather (phrasing it as a “mutual” breather may help him take it less personal, but if he asks, tell him you needed time to process how he treated you, don’t let him make it about what you said unless you did actually say some dumb shit) and don’t talk to him for AT LEAST 15 minutes. I say at least because depending on how wild he gets you might need to extend that to like 3 days or so, maybe even more. 15 minutes is just the average time it takes adrenaline to dissipate and I use that timing a lot to reapproach people at work.

Hope all this helps!

Apytele, 9 days ago (edited 5 days ago)

https://sh.itjust.works/pictrs/image/651cc409-55a8-4d2d-9a13-45c7f330f048.gif

Honestly the funny part is that the addiction med isn’t even really my specific subspecialty, it’s just that it is personality disorders and there’s a LOT of overlap in the behaviors they present with as well as just general comorbidity.

Apytele, 7 days ago (edited 4 days ago)

You’re confusing Al-Anon with Narconon

Apytele, 9 days ago

This is the best comment on this topic. Brief, but clearly and nonjudgmentally identifies the cultural context that easily could have led the original commenter to have come to this conclusion.

Apytele, 9 days ago

My favorite was the parent who told their kids their eyes change color when they lie. Now the kid closes their eyes real tight every time they lie.

Apytele, 10 days ago

I assume you’ve already tried white noise/a recording of moms voice, swaddling, ect? Cuz yeah other than all of that shifts is really the only thing to do.

Apytele, 10 days ago

As I understand it a good few nazis actually did flee to south America, so it’s not like they just scrambled that one together from random bullshit.

Apytele, 10 days ago

Ellie Goulding - Guns and Horses

Apytele, 10 days ago (edited 10 days ago)

Right like stimulants are super useful but more like for that guy in one of the world wars (who took way too many but other than that) and to his credit he did escape the Russians and lived to be like 70 or something. He also caught and ate a bird raw during this time period. Hang on actually let me go find the Wikipedia article.

Ok I’m back. I pasted the story here because I think it’s important to read BEFORE seeing the picture.

Koivunen was a Finnish soldier, assigned to a ski patrol on 15 March 1944 along with several other Finnish soldiers. Three days into their mission on 18 March, the group was attacked and surrounded by Soviet forces, from whom they were able to escape. Koivunen became fatigued after skiing for a long distance but could not stop. He was carrying his patrol’s entire supply of army-issued Pervitin, or methamphetamine, a stimulant used to remain awake while on duty. He consumed the entire supply of Pervitin, and had a short burst of energy, but soon entered a state of delirium and eventually lost consciousness. Koivunen later recalled waking up the following morning, separated from his patrol and having no supplies.

In the following days, Koivunen escaped Soviet forces once again, was injured by a land mine, and stayed in a ditch for a week, waiting for help. In the week that he was gone, he subsisted only on pine buds and a single Siberian jay that he caught and ate raw. Having skied more than 400 km (248.5 mi), he was later found and admitted to a nearby hospital, where his heart rate was measured at 200 beats per minute, and he weighed only 43 kg (94.8 lbs).

He died in 1989 at the age of 71.

The Article

It’s also my understanding (now, I’ve forgotten where I read it though) that his thought process on the matter was that when he was trying to get one out of the bottle but his gloves were too thick to get just one, so he said “fuck it I’m probably gonna die anyway” and poured them into his palm and just slammed then bitches back.

Apytele, 10 days ago

Stimulant withdrawal in general is just shit (cocaine withdrawal is well-known to cause suicidal ideation), but yeah I would rank nicotine as the worst personally. Of all the times a patient just about straight up punched me in the face, nicotine withdrawl is about 50% of my top ten.

That said, there’s some key differences between caffeine and nicotine that probably contribute to this:

1. the obvious: caffeine is completely flameless. Even a vape has a heating element that I don’t want anywhere near cotton bedsheets with oxygen literally on tap from pipes that run through almost every interior wall in every patient care area. In theory they can have as many cups of coffee as they want and it’s super easy to taper with half-caff (or similar) if they are ready to quit. (Caffeine also doesn’t put anything into the air that could harm someone with a respiratory disorder or allergy).
2. More importantly: The caffeine withdrawal management options we have replicate the sensory experience of consuming the drug MUCH more closely than nicotine. The hand-to mouth behavioral pathway centers the experience on almost every place in your body with dense sensory nerve clusters. The only way they could make either nicotine or caffeine more addictive is by finding a way to also involve your genitals. The patch just does not cut it, but half-caff just might.

Now my work does also have nicotine lozenges, which help with oral fixation and better replicate the peaking and troughing blood levels of intermittent use, but that doesn’t help with the hand motion. A significant portion of smokers are self-medicating either ADHD or one of the similar disorders, and you’ll notice they LOVE to fidget with their hands (remember fidget spinners? They were supposed to be for kids with ADHD). I’ve been trying to talk my work into buying those quit-go inhalers (it’s a plastic tube with menthol flavor) but you know how admin weasels are with their yacht money.

Apytele, 10 days ago

No but it’s a beatiful picture and I encourage you to keep enjoying your friend’s company!

Apytele, 10 days ago (edited 10 days ago)

And apparently even flourosis is only a cosmetic …illness? Honestly if Americans weren’t so obsessed with the cosmetics of teeth they might not even really notice. Like to the extent that people will strip their enamel in an attempt to whiten them. Even I had to look up what it was.

Apytele, 10 days ago

…the flourosis is caused by too much flouride. I’m saying people are worried about the side effects of too much flouride when they’re pretty much entirely cosmetic anyway. If you’re gonna “um akshully” on the internet at least Google it first.

Apytele, 10 days ago

My suspicion is that it’s supposed to be a prion which is a misfolded protein that causes other proteins to also misfold which eventually just makes a giant mess of your brain and kills you, similar to how a badly executed pivot table might crash your computer. The obvious difference is that we can’t reboot your brain. The closest we’ve gotten is probably ECT, but even that’s just mostly an in-joke between me and my coworkers about it just dumping all your neurotransmitters out so they can be marie-kondo-ed back into the right places.

Apytele, 11 days ago

Even better if he just paid her to do it or knew her mom through church and set him up or something else just totally mundane just to fuck with him. Like this:https://sh.itjust.works/pictrs/image/496be8dc-fb62-4965-ba27-30335cfbb0ee.jpeg

Apytele, 12 days ago

No, sorry!

Apytele, 12 days ago

No, sorry!

Apytele, 12 days ago

No, sorry!

Apytele, 12 days ago

No, sorry!