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Seirende

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Well, I'm officially desperate enough that we're looking at getting me ECT ASAP.
 

Carlos Danger

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Is there a good diagram for therapeutic index?
It is the difference between the dose of a drug that causes a therapeutic effect vs. the dose that causes toxicity.

Basically, "the safe dosing range".
 

RenegadeRiker

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I had a brand new frontier rental about a year ago. It worked fine but it just felt like I was driving something straight out of the mid 90s. It also had a weird steering feeling, it felt disconnected from the road but also really heavy.

It was also quite slow for a gas powered engine and didn’t seem to have great torque, which was weird given its specs.
Driving a rented Sentra in Massachusetts right now and this is life. I miss my Insight, has more guts than this thing.

Cape Cod CPR is extremely squared away and professional. They’re hosting a cadaver lab and it is better than the UMBC CCEMTP one I did back in ‘16 by a long shot. 12/10 recommended.
Also saw Cypress Creek got served a notice of termination of contract, 1 year lead time. I’m impressed. That admin team is willing to ruin the good reputation built over 45 years to protect themselves. And there’s no good reason for them not to cooperate with the forensic accountant from ESD11.
 

Akulahawk

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Electroconvulsive therapy
ECT as a procedure itself is actually pretty safe. It's done under sedation and with a short acting, short duration NMB (Sux usually). Then they electrically induce a seizure and recovery from this is usually pretty fast. When it works, it does help. When it doesn't work, I haven't heard of it making things worse. So, it's pretty much all upside.
 

Jim37F

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2100 and the crop duster decides to start spraying the fields around the station. I guess it’s a good thing that doesn’t happen at @Jim37F s department, they’d be thinking Japan wants round 2.
Not so much from our station itself (unless ypu climb up to the roof of the old hose tower) but in our neighborhood looks directly into Pearl Harbor (can see both Battleships Missouri and Arizona Memorial) For the end of WW2 celebrations (much muted due to the pandemic unfortunately) they had some old historical WW2 warbirds flying around. Pretty cool to see a PBY Catalina that actually served in the war flying overhead.

And yeah, when the F-22s at Hickam take off they tend to drown everything else out (especially at the Training Center which is right next to the airport and Joint Base Pearl Harbor Hickam, one of our Training Officers in Recruit Class was soft spoken and when the jets were flying we could miss whole lessons sometimes lol)
 

Akulahawk

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Except for the potential cognitive effects and memory loss
Some memory loss is probably the biggest downside of this. It's also why I said "pretty much" instead of "entirely" upside.

Now I'm not advocating for ECT at all. This is something that should be very carefully and thoughtfully considered before starting the regimen. There are some other experimental therapies as well, but I would first consider this before going down a more experimental track. The downsides of some of those can be quite significant, IIRC.
 

ffemt8978

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Good hot cup of coffee, paycheck double what I normally clear, and introduced a spammer to the ban hammer. Tis starting out to be a good day.
 

Seirende

Washed Up Paramedic
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Some memory loss is probably the biggest downside of this. It's also why I said "pretty much" instead of "entirely" upside.

Now I'm not advocating for ECT at all. This is something that should be very carefully and thoughtfully considered before starting the regimen. There are some other experimental therapies as well, but I would first consider this before going down a more experimental track. The downsides of some of those can be quite significant, IIRC.
I've done some brief reading on the risks... the memory loss usually resolves with time. I think for me the potential benefit will end up outweighing the risks.

I'd like to try esketamine; I've heard great things, but insurance doesn't cover it and it's friggin expensive.

Longer term I'm looking at DBT, that seems to have some efficacy in chronic suicidality.
 

Seirende

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Just updated my voter registration and requested an absentee ballot from the comfort of my couch
 

StCEMT

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I've done some brief reading on the risks... the memory loss usually resolves with time. I think for me the potential benefit will end up outweighing the risks.

I'd like to try esketamine; I've heard great things, but insurance doesn't cover it and it's friggin expensive.

Longer term I'm looking at DBT, that seems to have some efficacy in chronic suicidality.
I'm curious to see how ketamine will change in that regard with time. What little I have read seems promising. How much does it cost though?
 

Carlos Danger

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I've done some brief reading on the risks... the memory loss usually resolves with time. I think for me the potential benefit will end up outweighing the risks.

I'd like to try esketamine; I've heard great things, but insurance doesn't cover it and it's friggin expensive.

Longer term I'm looking at DBT, that seems to have some efficacy in chronic suicidality.
Have you looked into ketamine (the chiral form which is given IV) infusions? I don't know a lot about it other than the fact that they are purported to be nearly a miracle cure for some folks. Also I'm sure they aren't cheap, but it may cost less than esketamine, and anything that works well might be worth the cost.
 

Seirende

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Last I heard ketamine was about $400 per infusion, which is about what my psychiatrist said esketamine costs per treatment (which I think is IN for esketamine). That was a bit ago, I'll have to check into current pricing. You're looking at multiple treatments for either form.
 

Seirende

Washed Up Paramedic
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Actually, now that I'm looking into it, there is a patient assistance program for Spravato that I might qualify for. Esketamine would definitely be preferable to ECT.
 

Akulahawk

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If you can get assistance for something like esketamine, to make it far more affordable, that might be a preferable thing. From what I just read, you'll have to be on, or continue an oral antidepressant. However, it does appear to be very promising for treatment resistant depression. Also I haven't read (yet) that withdrawl has been a significant problem with esketamine compared to ketamines generally, it really does appear to be potentially a great option. If this doesn't work, you do have ECT as a backup, though that does have its own risks.

I've read (somewhere) that dissociative agents can be used for depression treatment. I just don't recall how effective some of those agents have been and who knows how effective they are long-term, after ceasing therapy with them.
 

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