True art

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 technically 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…

Yeah the classic patient education as to why they can’t be given more opiates when their POSS score is too high is that “if you think it hurts bad now, you do NOT wanna know what it’s like to get narcanned.”

Except when you have a personality disorder. People have no problem telling you you’re the evil kind of crazy and that’s why it’s fine for them to treat you like garbage.

I hate that you’re right about the electrolytes.

🤣

Psych nurse protip: “I wanna be able to give this my full attention so we’re gonna put a pin in this and circle back.” Then you literally just leave, possibly mid-sentence if they’re really that hyperverbal. Some acutely manic patients are so hyperverbal that I have to take their temperature under their armpit because they literally cannot keep their mouth closed around the probe.

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

That said all that serotonin is gonna make it HELLA hard to orgasm.

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.

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!

Trepanning, or as it’s now called, craniotomy, is where a section of the skull is removed / bored through. It’s mostly done for cerebral edema where there’s pressure inside the skull and on the whole brain (it can even fatally herniate the brainstem which means shoving it out through the bottom of the skull like a play dough extruder).

It’s wild to think that there was actually a reason ancient cultures did it. They way overused it and for the wrong things during certain time periods and it was horrifying that they were doing it without anesthetic, but I’ve also heard that it results in a basically instant return to orientation. So the few patients it would’ve worked on would have gone from deliriously speaking in tongues (I know it’s not any real language but that kind of confusion does at face value sound like something that would require an exorcism) and would suddenly just… wake up. Possibly with a spray of puss out of the wound.

There’s a lot of old timey medical stuff we still do, it’s just now we do it with anesthetic and sterilization. Medically sterile maggots are used to clear out dead and infected wound tissue and some surgeons who work on structures with delicate vasculature like hands will use leeches to prevent swelling from blocking off bloodflow to the area while it heals. I’ve spent most of my career working at places that do electroconvulsive therapy (again, under anesthesia) for severe treatment resistant depression and catatonia (like so bad they can’t move or eat and need to be turned, cleaned and fed with a tube), and one time I worked with a patient who had had a frontal lobectomy (used to be called a lobotomy) for a severe seizure disorder that wouldn’t respond to medication.

Anyway Gage’s case was more on the subject of localized trauma and what injuries to the brain a human can survive. In particular it began our understanding that frontal brain injuries are usually much more survivable than ones to the rear, but that they can effect personality and in particular emotional and impulse control.

This is funny because I do actually have a strong background in psychiatry which has a fair amount in common with both neurology and psychology and Phineas Gage’s case is actually a pretty famous one in regards to the historical evolution of all three of those fields.

yeah it read plainly as a reference to me but people also tell me other people don’t know the kinds of things I do a lot of the time.

Honestly it’s not even the CPR that particularly bothers me, it’s the intubation and the stuff after. I’ve worked with so many patients who don’t have a lot of working neural tissue left and their family just has them medically tortured for years because they want to see them blink occasionally. Next time I update my documents I think I’m going to add that if my family wants something to happen to me that I have to be held down for, they have to be in the room. If they can’t stand to watch / listen to me while it happens, they’ve no right signing off on it.

um. yeah. they do that after regular surgery too. a shitton of sedatives will do that. ect is also associated with temporary memory loss but it wears off just as quick as with a regular seizure, a little faster even. Also every time I’ve been in the procedure room for it the most that happens is the person’s feet wiggle a little for a few seconds?

idk maybe it’s just that I’ve seen way more terrifying medical shit done when I was sitting suicide watch in the ICU (I’m a DNR after seeing what it takes to keep someone alive at the brink of death) but it was like the least unsettling thing I’ve seen in a procedure room. In my OR clinical rotation the surgeon was literally HAMMERING that Lady’s titanium hip into place for 6 hours.

Shit sounded like a dwarven mine in a fantasy movie just DING DING DING with a fucking hammer in a sliced open little old lady for 6 hours straight. THAT was disturbing. Feet wiggling for a few seconds is nothing. especially not when you see it bring someone back from catatonia so deep they can’t eat.