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Thread: Independent Nurse Practitioner's straight scoop on medicines

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Thanks Dennis and diteras, thank you SO much for taking the time to respond to me. It is much much appreciated! Would like to know if you have any thoughts on what seems to be an epidemic of hypothyroidism. I don't have it but a few people I am in touch with do. And a few members of my immediate family, too. I wonder if it is on the rise or is typical in an aging population.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Searcher - thank you very much for that - no I hadn't (to my shame) heard of Illich, but I am not so arrogant as to think that my views are original - there is a lot I don't know and all I will do is try to speak my version of truth - which may be right or wrong. Not that clever me.

    ''Medicalisation of everything'' is something I think I put on my Avalon application. It is something I see a lot of. Maybe I am best with practical examples ?- here's a couple - This happens a lot.

    Imagine a lady for e.g. - in her eighties - living alone - a number of chronic health issues , she is increasingly aware of her life fading away - her friends are expiring or becoming less able - maybe some going into care - her family have moved away - she is proud of them and their success- she doesn't want to be a burden on their busy lives and family struggles - and like all of her generation sees asking for help as the beginning of the end-game. She is l being forced to confront the reality of mortality and worse - but she carries on. Then something happens - it could be a little or a big thing.
    Maybe her pet dog or cat dies - maybe a good friend or neighbour is taken ill - maybe she just drops a treasured ornament or looses her keys? The trigger isn't necessarily proportional.
    She becomes very unhappy - because she has a lot to be unhappy about. So she sees her GP. She wants to talk to someone really. But she leaves the practice after her standard 15 minute consultation with a prescription for a (usually) sub therapeutic dose of an antidepressant. Of course it wont work - because she isn't clinically depressed, she is chronically unhappy and that is different - plus - if she was depressed to the level she is apparently displaying - she would need a far greater dose of antidepressants than her physical condition would tolerate. She has no information about this treatment - she cannot remember what the doctor told her - because she is so embarrassed by her self perceived weakness. She now has a mental health profile. This can become the answer to any issue she brings up with health in her medical future. Any problem she now has that defies easy explanation will be put up as 'health anxiety' .

    This can now go many ways and usually it doesn't end well. I meet people who have been taking antidepressants for twenty years and they don't know what they are or why they were given -

    classic example -

    Lady in her eighties comes to clinic (this is not a composite) with her daughter. I ask her why she has been taking dothiepin aka dosulipen since 1992. ''What is it ?'' I explain its an old school antidepressant which has such a bad rep that we cant even find a reason to re-invent it - reasons - lethal in overdose/and see below (I can never understand why we have so many lethal od drugs to give to people who might want to use them to that end - its like giving a child dynamite and matches and telling them to 'be careful' 1)

    So when we discuss this med it appears two things happen in 92. Firstly her husband died and secondly she has a myocardial infarction (MI)

    Either way this is bad. why - because dothiepin is known to be cardio toxic (2) this was suspected for many years - so no excuses
    scenario 1 - she became depressed and GP prescribed then she had an MI - and was left on this drug despite the symptoms of depression (aka unhappiness/grief) having abated.
    scenario 2 - she had an MI before her husband died and someone thought it a good idea to treat her grief with an potentially lethal medication - in her circumstances.

    sorry - too much I know but yes.... it is not a good relationship we have with pharmaceutical products worldwide. They have their place but it is totally out of proportion now.

    I will read and digest Searcher - thanks again !


    1 https://bnf.nice.org.uk/drug/dosulep...ochloride.html

    2 https://www.bmj.com/rapid-response/2...-heart-disease

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by Dennis Leahy (here)
    Quote Posted by diteras (here)
    ...PS Denis how the heck do I change the title???? ...
    Done. I hope that helps to give this thread the attention it deserves. -Dennis
    ta buddy btw is that you or your younger brother on that photo? I need some of that elixir

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by AutumnW (here)
    Thanks Dennis and diteras, thank you SO much for taking the time to respond to me. It is much much appreciated! Would like to know if you have any thoughts on what seems to be an epidemic of hypothyroidism. I don't have it but a few people I am in touch with do. And a few members of my immediate family, too. I wonder if it is on the rise or is typical in an aging population.
    AutumnW thank you again - I am pretty sure that levothyroxine was (if not the most then at least in the top few) prescribed drug in the US. Why is this I did wonder. The problem that I (again my opinion) am becoming increasingly concerned about is that 'we' as in the medical profession, are increasingly treating the human body as if it is a line up of disconnected buckets - of course it isn't - it is one big bucket with different compartments. You need to see the whole - and it aint easy.

    Endocrine disorders (1)are not my speciality but they are very relevant to what I do - that is why any memory assessment should have current bloods as an accompaniment and you would be surprised how this is ignored in clinical practice ''mxyedema madness'' (2) is not as rare as literature would have us believe. I am aware of several cases.

    I am not answering your question am I? Well - bit of a cop out, but we are living longer, so maybe that is part of the answer. Also we may be better at spotting these things and people are more aware of their health - so get checked more? There are also incentives for doctors to find and treat in UK - dunno what happens elsewhere. Is it something environmental would be another question - background radiation even?

    The endocrine system is very relevant to many things - it includes the pineal gland for one thing - a source of endogenous theosophic experiences they say. Well covered by many, but certainly in lab rats a substance akin to Dimethyltryptamine has been observed. .Who needs to go to Brazil for a trip eh? Not rodents for sure.

    I have some pretty clear but 'out there' theories of mine own. Related to your question if not directly

    for consideration only -

    If you have a treatment which is being doled out by the ton - imagine the number of tablets rolling out of some factory somewhere - by the million weekly. These are generally not coming from top ten pharmaceutical companies - this is the grunt end - the 'out of patent' production line. Can we be absolutely sure that every batch is exactly what it should be?I know they are tested but they cannot test every pill can they?
    I have heard doctors saying this - it is worth thinking about - so if you can insist on non generic i.e.branded (by implication more expensive) meds - you probably have more of a chance you are always getting what it says on the tin.

    not much of an answer but I will do some more serious research -promise

    love





    1 http://www.btf-thyroid.org/informati...symptoms-guide

    2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959026/

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by diteras (here)
    Searcher - thank you very much for that - no I hadn't (to my shame) heard of Illich, but I am not so arrogant as to think that my views are original - there is a lot I don't know and all I will do is try to speak my version of truth - which may be right or wrong. Not that clever me.

    ''Medicalisation of everything'' is something I think I put on my Avalon application. It is something I see a lot of. Maybe I am best with practical examples ?- here's a couple - This happens a lot.

    Imagine a lady for e.g. - in her eighties - living alone - a number of chronic health issues , she is increasingly aware of her life fading away - her friends are expiring or becoming less able - maybe some going into care - her family have moved away - she is proud of them and their success- she doesn't want to be a burden on their busy lives and family struggles - and like all of her generation sees asking for help as the beginning of the end-game. She is l being forced to confront the reality of mortality and worse - but she carries on. Then something happens - it could be a little or a big thing.
    Maybe her pet dog or cat dies - maybe a good friend or neighbour is taken ill - maybe she just drops a treasured ornament or looses her keys? The trigger isn't necessarily proportional.
    She becomes very unhappy - because she has a lot to be unhappy about. So she sees her GP. She wants to talk to someone really. But she leaves the practice after her standard 15 minute consultation with a prescription for a (usually) sub therapeutic dose of an antidepressant. Of course it wont work - because she isn't clinically depressed, she is chronically unhappy and that is different - plus - if she was depressed to the level she is apparently displaying - she would need a far greater dose of antidepressants than her physical condition would tolerate. She has no information about this treatment - she cannot remember what the doctor told her - because she is so embarrassed by her self perceived weakness. She now has a mental health profile. This can become the answer to any issue she brings up with health in her medical future. Any problem she now has that defies easy explanation will be put up as 'health anxiety' .

    This can now go many ways and usually it doesn't end well. I meet people who have been taking antidepressants for twenty years and they don't know what they are or why they were given -

    classic example -

    Lady in her eighties comes to clinic (this is not a composite) with her daughter. I ask her why she has been taking dothiepin aka dosulipen since 1992. ''What is it ?'' I explain its an old school antidepressant which has such a bad rep that we cant even find a reason to re-invent it - reasons - lethal in overdose/and see below (I can never understand why we have so many lethal od drugs to give to people who might want to use them to that end - its like giving a child dynamite and matches and telling them to 'be careful' 1)

    So when we discuss this med it appears two things happen in 92. Firstly her husband died and secondly she has a myocardial infarction (MI)

    Either way this is bad. why - because dothiepin is known to be cardio toxic (2) this was suspected for many years - so no excuses
    scenario 1 - she became depressed and GP prescribed then she had an MI - and was left on this drug despite the symptoms of depression (aka unhappiness/grief) having abated.
    scenario 2 - she had an MI before her husband died and someone thought it a good idea to treat her grief with an potentially lethal medication - in her circumstances.

    sorry - too much I know but yes.... it is not a good relationship we have with pharmaceutical products worldwide. They have their place but it is totally out of proportion now.

    I will read and digest Searcher - thanks again !


    1 https://bnf.nice.org.uk/drug/dosulep...ochloride.html

    2 https://www.bmj.com/rapid-response/2...-heart-disease
    Oh diteras, I am sorry if my post came across as inferring that you were not being original.... this is not what I intended at all! I was rather trying to say that you might find a “fellow traveller” in Ivan Illich. I should have been clearer.

    I hope you find Illich interesting, I’ve been reading one of his books about reading (which is my vice, virtue and everything in between)... it’s illuminating!

    ~~~

    I feel so sad when I read the examples you posted. Here are these people who have so much to share, so many stories they could tell and the only people who seem to be available to listen are in a medical role. The loneliness and isolation is heartbreaking.

    I guess 50 years ago people might have found companionship in their local church but religion has faded from many people’s lives. I’ve read very depressing articles about how isolated some elderly people are in Japan, often dying in their homes and not being discovered for days or weeks.

    There must be something awry in our society when the old have only clinic staff to speak to.

    ~~~

    *I have loved the stars too dearly to be fearful of the night*

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Dear Diteras (sorry for the misspelling but lower-casing your name seems somewhat demeaning), a very warm-hearted if slighted belated welcome. I didn't notice this thread until this evening, but I'm extremely happy I did. You have a unique and highly infectious writing style for which I fear there may well be no antidote. Book on the horizon or would that be a too much of a legal quagmire? Either way I'm looking forward to more of your tales and insights.

    ps: prop's for bigging up Richard. D. Hall.
    the greatness of a nation and its moral progress can be judged by the way its animals are treated --- Gandhi

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by Akasha (here)
    Dear Diteras (sorry for the misspelling but lower-casing your name seems somewhat demeaning), a very warm-hearted if slighted belated welcome. I didn't notice this thread until this evening, but I'm extremely happy I did. You have a unique and highly infectious writing style for which I fear there may well be no antidote. Book on the horizon or would that be a too much of a legal quagmire? Either way I'm looking forward to more of your tales and insights.

    ps: prop's for bigging up Richard. D. Hall.
    Akasha you are too kind. For what it's worth 'diteras' came about through me, with my first computer, circa 1998 (dial up modem -how did we eh? - old episode of Simpsons with Homer doing the impersonation still makes me roar) trying to get something which demon internet (anyone remember them?)would accept as a handle for e mail --- I got to about the nineteenth million attempt and hit keys at random.....and it stuck. People have tried to make something of it ever since....maybe it was something --- I could message Gigi Young? I am sure she would know .........having a Gigi moment now.......###sigh##........back. ..So a book ---- I am too lazy. Maybe one day eh?
    I am so pleased that you find my stuff tolerable and I promise I will do my best to keep it 'real' . Thank you --- I really don't think too much when I write this down --is that obvious? ...probably is eh ? ...not trying to make out that I am anything special --- I am not --- just... cant stop seeing-- and cant help commenting on the bs of what is seen --in fact the people who work with me would likely say I am toning it down so far, Time yet.

    RDH is a good man - glad you approve--not everyone's glass of tea but -damn is he genuine and hardworking (whether you agree or not )
    Last edited by diteras; 12th July 2019 at 22:36.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Oh diteras, I am sorry if my post came across as inferring that you were not being original.... this is not what I intended at all! I was rather trying to say that you might find a “fellow traveller” in Ivan Illich. I should have been clearer.

    I hope you find Illich interesting, I’ve been reading one of his books about reading (which is my vice, virtue and everything in between)... it’s illuminating!

    ~~~

    I feel so sad when I read the examples you posted. Here are these people who have so much to share, so many stories they could tell and the only people who seem to be available to listen are in a medical role. The loneliness and isolation is heartbreaking.

    I guess 50 years ago people might have found companionship in their local church but religion has faded from many people’s lives. I’ve read very depressing articles about how isolated some elderly people are in Japan, often dying in their homes and not being discovered for days or weeks.

    There must be something awry in our society when the old have only clinic staff to speak to.

    ~~~



    Searcher --- no need to be apologising --- my tone was off and I wasn't suggesting that you were inferring anything - I apologise to you-- just saying (badly) that I know this has been said before and --in many ways that makes it more poignant.

    I hate leaning on others wisdom - it always seems lazy-- but for some reason this Lawrence Durrell remark stuck with me (who?! I hear you say--quite right to say it btw---Sartre he aint) ''History is an endless repetition of the wrong way of living''

    We have to stop this lemming rush --- if we can. Not easy.

    thank you for being interested --it means more to me than I could say
    Last edited by Constance; 16th July 2019 at 07:22. Reason: fixed errant quote formatting

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    #3

    ‘’Human beings seem to have an almost unlimited capacity to deceive themselves, and to deceive themselves into taking their own lies for truth.’’ (1)

    Why do we do it and what for?

    I think a lot about the business of living -- I did so before this job possessed me. I think life starts the minute after you confront death. I was very young when this meeting scheduled.
    It happens.

    After that (arguably still), things got a bit ‘J G Ballard’ (to borrow a phrase). I know that isn't unique -- coping with change and ‘’trauma’’ - especially in childhood experiences - is the equivalent of sliding down a knife edge. At least my knife was short-ish. It isn't always so - some knives slice more than flesh - some mutilate the soul.

    Those that get cut to bits often never recover, while some use it somehow and it makes them. Success covering or masking an unpleasant reality is a strange thing - akin to building a luxury mansion in Centralia - there is no way of knowing how long if ever it will take,but you know one day it could end very badly -- but it might not - how would we know if it didn't? ‘No disaster today’ isn't news.--- I often consider that the most heroic acts of human sacrifice will remain forever unknown.

    You wonder how they, these damaged fellows of ours, could have been -- what they would have done -for better or worse. You wonder if the visible casualties of this, the ones you see lying bleeding on life’s metaphorical roadside, are actually displaying emotional integrity or honesty. Like iconic martyrs to inhumanity.

    I am willing to lay odds that there are many people with the most horrendous experiences, which they have buried beneath layers of self administered psychological camouflage.People who will never do the big ‘reveal’ . Ever. Is that strength or weakness - or is it some evolved coping which once learned became the immovable bedrock of their self? In abuse, it also could be the influence of the tormentor haunting them (from the grave) like a power vampire --- It (their contracted ‘front’)becomes the thing which normalises or apparently stabilises. It is the veneer covering the empty, betrayed and emotionally stunted spirit of a broken and frightened child that stays in the darkness ---forever.
    Why do this? -again my opinion (but probably not original)
    David Eagleman,(2) neuroscientist, professor at Stanford, spoke of death’s three stages - the moment of physical death - the ritual//funeral death and... - ‘’ The third is that moment, sometime in the future, when your name is spoken for the last time.”
    Maybe in keeping the name in the darkness with them, they are insuring that death is completed. Part of the complex motivational rationale for the actions of sociopathic serial killers is ’immortality’’. Notice I didn't use names. Shame on you Mr Effron --- stick to flashing your abs in future…

    I grapple with mental illness as a concept because of these things (not Zac’s abs, although they do upset me) --- because I am aware of human experience as subjective truth, I can never stop asking why. Often this is in only an internal debate. You know when you have reached the limits of your security pass into someones very private inner sanctum.

    Why this is important is because it’s important.

    So...back to what is known.

    I have touched on medicalisation and here is how it really can be harmful and downright divisive.

    Case study -
    Lady in her seventies. Living alone in a small, warden assisted older persons bungalow - She is on the radar of police, ambulance service, GP, social services, district nurses, housing association - and is a constant source of concern to her son and daughter who are both in their fifties. Lets call her Molly. She is recently widowed.
    Molly has had several visits to hospital - taken by police when found out of doors apparently ‘confused’ - and several admissions. She has been treated speculatively for the standard ‘urinary tract infection’ the most common cause of confusion. She is assessed by psychiatric services on one admission because she is allegedly threatening suicide. - You don't have to do much in the world of ass covering, Chinese whispering, scared of their own shadows, public services for this to happen - a casual ‘’sometimes I wish I could go to bed and not wake up’’ is enough. Everyone wants to pass risk parcels on - even if their common sense tells them it is not required - I/we are often the ones who get to unwrap them.

    She has three care calls a day - the carers control her medication and prompt meals. These calls are both helpful and unhelpful - dependent on who is making them and what Molly’s assessment of them concludes.

    Why is she such an ‘item?’

    Molly is also doing things which are seen as risky and (frankly) a damn nuisance. Ambulance and GP are clocking multiple calls daily -one week over fifty emergency calls to ambulance. - they have a checklist of symptoms and rules - if the boxes are ticked they have to go - which isn't entirely a bad thing. The GP is being similarly hit with calls - family are getting over ten calls a day each. If the calls get no response the stakes are raised - she is placing herself in the road, walking the streets in her nightwear, threatening self harm……. None are done with the obvious absence of control or awareness of consequence that someone with an acute or chronic mental condition would display - but to the tabloid sensibility we all have to take as our judge and jury they are close enough.

    So Molly is seen by a psychiatrist. She has no psychiatric history prior. He thinks - not without justification - that she is suffering from depression secondary to an adjustment disorder. She has a vulnerability to hyponatremia (low sodium na+) so cannot be treated with a selective serotonin reuptake inhibitor (class of meds known as SSRI’s which include fluoxetine aka prozac,citalopram and the ubiquitous sertraline) so commences a trycyclic.(lofepramine)-

    Of course it doesn't work. Symptoms don't always match treatment if something else causes them. It isn't that simple even when it is.

    The family are as mad as hell. They now have someone to blame.

    Put simply this is what they feel/say- ‘Mum is mad and she is being treated by Mental health. Nothing has changed - we are not helping her them or anyone else - what has she got anyway - we think she’s demented - she needs to be ‘put away’ - we are giving her not enough/too much/the wrong medication -we (as in me) are useless - we don't care.’

    I don't blame them.

    So we have a meeting - all of the above are represented - even the cops -and before this meeting I read through her story.

    I open the meeting with an admission that we have not helped Molly and I go on to say that I think I know why we haven't and cant. I ask her son about her and say that I realise she had some tough times - he says’ no she didn't ‘and his sister agrees.

    So I go through what I have learned - her family tick each box for me in the ‘yes’ column.

    Molly was the sixth child in a family of eight
    When she was six years old her mother was imprisoned for prostitution
    Her father then committed suicide
    She spent the next ten years in care
    When in care she was abused sexually/emotionally/physically
    When she left care she met her husband
    She had children and worked hard but had few friends
    She never showed her children affection and was always distant - not a loving mother -’she never hugged us’
    Dad was mum and dad to us - he took a lot of physical and verbal abuse from her all the time
    Mum was always falling out with people and we had to move around a lot ………..I could go on but it is already sad enough eh?

    Any wonder they were angry? At least dad modulated the pain a bit - but when he died the buffer went - she was exposed to something that she had only experienced as pain and betrayal with no trust or love - the planet of other people - she only saw the world as an emotionally betrayed child of six would -and she still does.

    So ……...call it what you want - I would go for dis social personality disorder. Labels shcmables.

    If you want a little sketch to help you determine the difference between ‘axis 1( usual mental conditions and axis 2(personality issues) - then here it is - take anankastic personality disorder - symptoms may be hoarding - compare this with OCD - symptoms may be hoarding - the person with OCD is tortured by their compulsion - they know they have a problem - the person with APD has no problem - they have a problem only with you thinking they have a problem. Another oversimplification but I am getting tired now

    Back to Molly -

    Can we cure it? Nope too late by about 60 years to even try.

    Can we detain her for it or place her in care - Nope wouldn't work too disruptive

    All we can do is explain ‘why’ and hopefully place some boundaries.

    Poor Molly - all she leaves behind her is all she ever was given. Bad memories.

    It isn't fair is it? What did a six year old do to deserve that ....speak up Mr Wilcock............nothing.

    Can I now include some poetry? It’ll probably get me banned but here goes …..actually no here’s a link but warning you it has swearing ……

    https://www.goodreads.com/quotes/669...d-dad-they-may




    I think I have said enough today - thank you for your patience




    1 R. D. LAING, The Politics of Experience/The Bird of Paradise (1967)
    2 David Eagleman Sum: Forty Tales from the Afterlives(ISBN: 9781847674272) (2016)
    Last edited by diteras; 14th July 2019 at 01:40.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Wow - In awe of such powerful musings and expression, Diteras!

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Thank you for writing of trauma and death. Not many people do.

    I have been thinking about death for some years - not in a morbid or suicidal way, more as something that is an inherent part of life. Perhaps it comes from having grown up in a time and place where images of pain, suffering and death were present in society.

    ~~~

    Thanks for the books you mention - “Sum: Tales from the Afterlives” by David Eagleman and “The Politics of Experience/The Bird of Paradise” by R.D. Laing - both look interesting.

    It seems we have been exploring other worlds and what lies beyond death for many thousands of years.... I recently stumbled on a strange set of Ancient Greek artefacts: the (Orphic) gold tablet or “totenpass” (https://en.m.wikipedia.org/wiki/Totenpass). These inscribed metal tablets have been found at ancient burial sites.

    A little about these “passports for death”:
    Quote The objects in question are a series of gold tablets of very small dimension (they vary between 8 and 4 cm. wide and 3 to 1 cm long).

    The writing that appears on them is minuscule in size and very careless ...

    They are found in graves, but the limited number of graves that have yielded documents of this type, compared to the thousands that have been excavated, indicates that the users of the tablets were a minority group, with a certain unity of beliefs, probably initiates, or followers of a religious movement...

    They have come to light only in a few places, and differ widely in date, with almost six hundred years between the oldest, the one from Hipponion, c. 400 B.C., and the most recent, which appeared at Rome and is datable to 260 A.D. The majority of them, however, date from between the 4th and 3rd centuries B.C.
    From: p. 2, “Instructions for the netherworld : the Orphic gold tablets”, Alberto Bernabé Pajares; Ana Isabel Jiménez San Cristóbal, Leiden ; Boston : Brill, 2008.


    And here is what they say:
    Quote Tablet from Hipponion (c. 400 B.C.), Museo Archeologico Statale
    di Vibo.
    First edition, Pugliese Carratelli (1974) 108 f.

    This is the work of Mnemosyne. When he is on the point of
    dying
    toward the well-built abode of Hades, on the right there is a
    fountain
    and near it, erect, a white cypress tree.
    There the souls, when they go down, refresh themselves.
    Don’t come anywhere near this fountain!
    But further on you will nd, from the lake of Mnemosyne,
    water freshly owing. On its banks there are guardians.
    They will ask you, with sagacious discernment,
    why you are investigating the darkness of gloomy Hades.
    Say: “I am the son of Earth and starry Heaven;
    I am dry with thirst and dying. Give me, then, right away,
    fresh water to drink from the lake of Mnemosyne”.
    And to be sure, they will consult with the subterranean queen,
    and they will give you water to drink from the lake of
    Mnemosyne,
    So that, once you have drunk, you too will go along the
    sacred way
    by which the other mystai and bacchoi advance, glorious.
    From: From: p. 9-10, “Instructions for the netherworld : the Orphic gold tablets”, Alberto Bernabé Pajares; Ana Isabel Jiménez San Cristóbal, Leiden ; Boston : Brill, 2008.
    *I have loved the stars too dearly to be fearful of the night*

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Searcher you have some fantastic insights - you are dragging me up to another level. Good. I need to process some of this as I feel very much like I walked into class half way through the course --- which is pretty much how Daniel List's (dark journalist on his you tube channel) 'X series' makes me feel. I have also enjoyed Gigi Young's (be strong here... no sighing).....~##..sigh..## .....Sorry..... back .. series on the occult ''in plain sight''. Link for last one #4 here -



    Which you may enjoy.

    So need some entry point for this info stream and then will hopefully pick up the pace.

    This Friday through Sunday will be in Manchester for ''Awakening'' conference. link -

    https://www.awakeningufo.com/?lightb...eid=d98c342133

    if anybody is going and wants to meet or say 'hi' let me know and I will wear something obvious or put up a flag

    Thanks again everyone - for reading - for commenting and for adding such interesting possible sub-topics as Searcher.

    Love.
    Last edited by Constance; 16th July 2019 at 07:19. Reason: formatted youtube link

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    It isn't difficult to look after someone.

    That was something an ex colleague of mine used to say often. He used this observation in the context of a sad reflection on how we make it so fecking difficult to do so. It is only recently that I have realised this has implications beyond the personal interpersonal or even the humanitarian.

    Of course you may not agree and all respect if you do. I try in these little flashes of un-wisdom to give you all something honest as my observations and if in so doing you feel that I am off message then we will never fall out. Life is too short to argue about seat positioning on a crashing aircraft….’’ I insist on being found horribly mangled in nothing less than an executive class velour….’’

    I think language and history are exceptional things. Human behaviour too - we are not as unpredictable as we think. Mice in a maze is all.
    I think about the corruption of language and the inevitable bastardisation of thought which follows that corruption - likewise the ways that thought and our story as people can be manipulated for ends which do not tally with reality and how we mesh these things into our everyday lives. Without question. - even although we know
    These matters affect people and they make them affected and yet they blame something else -- we are a collection of symptoms who are in denial of the cause of them --- mice in a maze. - illness is not always organic sometimes it is mondo-organic - remember I said earlier that ‘everything is connected’?…..ok. Here we go…. Fasten your belts...

    I am interested professionally - and as a human being - in what we would term ‘’personality disorders’’. Why? because it is a subjective terminology as much as a diagnosis - a descriptor of the human condition that is poorly understood and little discussed. I say again ...It is a subjective terminology . It is also ,in my opinion, a worldwide disease which endangers our species. It is a worldwide malaise would be more correct and it is encouraged. Of that I have no doubt.

    Here's a little opener to chew on…..

    ’Personality is the supreme realisation of the innate idiosyncrasy of a living being. It is an act of courage flung in the face of life, the absolute affirmation of all that constitutes the individual, the most successful adaptation to the universal conditions of existence, coupled with the greatest possible freedom of self-determination.’’ (1)

    Personality has also come to mean celebrity. So what does the jolly old dictionary say on that little variation/ change that CGJ didn't get to in his reverie?......

    ‘’The state of being well known’’

    hmmm……..

    Origins - ‘’ Late Middle English (in the sense ‘solemn ceremony’): from Old French celebrite or Latin celebritas, from celeber, celebr- ‘frequented or honoured’.’’


    I give that up. Kim Kardshian’s unfeasible arse is ‘’frequented or honoured’’.
    By Whom? ...By enough people to make it big (ohhh yerrr - I have no shame)---- big enough for it to waste precious seconds of brief existence that we have considering it’s relevance. ……. More than a distraction then --- a dark icon. An arse icon of despair. The buttocks of madness descending into the bum-cleavage of oblivion.

    Now here is a digression from a digression ---- please be patient with my dumbosity. I will pull it together.

    On Sunday I was in Manchester UK.

    I had been to a conference and was filling in a little time before an appointment with friends --- so I went to the Imperial War Museum (north) ref 2 ---- it was ok... But like a lot of so called museums these days worldwide had a spun narrative --- you were told what to think, what to fear and the goodies and baddies were well defined …. Massaged the failures away, is what it did - and subtly excused the suffering as ‘required sacrifice’’ to some extent - although the holocaust was given some slightly higher prominence ….. (Yerr ok maybe it should be ---you think?? )---and what about Holdomor, Cambodia, Rwanda, Indonesia, Ireland, Bangladesh, California, Queensland…and on and on and on)...

    Inhumanity is repetitive and relentless in ignorance -morally bankrupt and doomed if you consider it --- we allow these things to happen- in the past present and future. We do so through a total failure to understand ourselves. Madness or deformed views of self are not abnormal in an abnormal state of being --- how can they be? Madness or disordered perception ...where is the definition of what equals what?
    I try to be calm in the face of such realisations. Subjective remember...maybe it's me who has it wrong….


    So ….back to the museum. There is a special exhibition - the horrors inflicted upon the poor people of Yemen. No politics, but what/who the actual effing heck is letting (and I use the word advisedly) that happen? Not me I hope. I guess it is tho’. It is us.
    While 'we' are looking at pictures of Kardashian arses and reading pointless badly written nonsense about Prince Harry and Megan, or what Trump said to his favourite pet carrot, our fellow human beings are dying like bleached germs in a public toilet...

    …...…...so I get to nearly the end of this horror reveal and there she is -- an attractive lady who I would place in her early thirties - she has a guy with her who is tall and equally sharp - - - they are looking at a series of 'inset into wall' screens depicting the struggles of Yemeni children. I am frozen.

    Here we are told (never mind the cholera and the hyperinflation causing the endless escalating cost of drinkable water) of a 6 fold increase in under aged marriages for girls. This a throwaway that fills me with..well.. utter despair …. The horror, the horror -- after a while you get used to it do you not …. That is something we should never be and yet we are-- …. enough...I am not even sure what I am doing here now - am I just some sort of pain voyeur who thinks its ok to look at this because the building has ‘museum’ in the title……??

    Maybe.

    Now I feel that crushing futility which I see in others - it is all too sad - the temple to repeated mistakes was a mistake for me ...why you say ...it happens... do something... then futility will be swept aside --- but it wasn't that that made the floor slope... - too simple
    It isn't the unsubtle factionalised genocide of poor defenceless oil-less children, who our media have been told to regard as insignificant, that offends me most -- although it does offend me - make no mistake -but offence is what you see 'in vivo' - so in this moment I see the epitome of decadent disregard for humanity-

    It is her ass.

    This creation is beyond the description of biblical verse. It starts near the small of her back -it extends, horizontally, a full five/six inches outwards. It then curves in a perfect arc about a further two/three inches out and descends down for 9-12 inches before turning towards her upper thighs about two./three inches inward from its original vertical starting point. She is wearing quite large stack heels.Thank god.

    You could rest a tray of drinks on that ‘thing’.

    So I started to write of personality disorder as a concept - and I promise this is something which is close to me and something of which I will post again….. But first I ask you this…..
    How can we, in this world of such bizarre cruelty, be surprised that people can't cope with life, when they are confronted by these visual assaults? - When they are made demands on by these twins of human inhumanity - a meta analysis of cruelty and despair (which we are doing eff all about btw) - juxtaposed with a personification of our stupidity and vanity. It's not even subtle and yet no one seems to see it.

    If you want to have a brief touch-down on the planet stupid try looking at this ---(ref 3) normalise the abnormal -- ok.. I’ll just get on with it then shall I?


    So…..it’s ok to kill kids as long as we pay them the respect of looking at it with solemnity in the right setting - and its ok to spend enough cash that would keep them alive on something you can only see in a mirror. I wonder what the little girls in Yemen who are being violated tonight think….

    I am sorry if anyone is offended and if so I will withdraw - not usually so dark

    Everything is connected.




    1 [C.G. Jung, "The Development of Personality," 1932]

    2 https://www.iwm.org.uk/visits/iwm-north

    3 https://www.nhs.uk/conditions/personality-disorder/
    Last edited by diteras; 26th July 2019 at 05:57.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by Mike (here)
    Strat ive been given all sorts of BP meds. almost killed me. toprol slowed my heart to such an extent that i feared it might just stop beating altogether. my lasting memory of that week i took it was the night i awoke and did jumping jacks till i couldn't stand....i was certain if i stopped moving my heart would stop too.

    some meds *are* useful, as Autumn points out...but ugh, i would not recommend those bp meds to anyone.
    Yes, the blood pressure question is interesting, I was on Coversyl for a time, but I am not on anything currently, I eat a lot of Garlic/chilli and I walk regularly, this suits me better. A bit of Aspirin daily is good.
    The World Wide Web is our global publishing house. If you seek to publish and develop your reach: https://www.webstruct.xyz

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    I have found that most of the medical professionals I encounter actually get a bit annoyed when they have you write down all the prescription meds you are on, and you have 0 to list; like either you are lying, or in denial about your health or something. It gets worse the older you get, too.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    diteras, thank you for your post this morning. You raise important things.

    How does one look at and really see what is happening? How does one see the suffering and the pain and the distress and not be consumed by it? Or look for an escape from it? How does one witness the suffering and yet, still take part in the world?

    ~~~

    I am haunted by a couple of news stories I watched as a child of 8 or 9 growing up.

    One was a story of how people travelling to work on the train were targeted by groups of freedom fighters and thrown off the trains (while they were moving). They were thrown off because they were seen as supporting the regime by continuing to work for it. I can never forget the shock and horror I felt on seeing this story: a kind of screeching wail that reverberated through me.

    Another was a news report about a small group of people who had been necklaced (https://en.wikipedia.org/wiki/Necklacing) by a group of fighters (who were associated with a soccer club). They had been tortured and killed because they were suspected of being spies, of having dual allegiances. I still cry about this today. It shakes me to my core. And I feel that perhaps I am the “witness” that this event needs.

    ~~~

    Thank you for your posts.
    *I have loved the stars too dearly to be fearful of the night*

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by Cara (here)
    diteras, thank you for your post this morning. You raise important things.

    How does one look at and really see what is happening? How does one see the suffering and the pain and the distress and not be consumed by it? Or look for an escape from it? How does one witness the suffering and yet, still take part in the world?

    ~~~

    I am haunted by a couple of news stories I watched as a child of 8 or 9 growing up.

    One was a story of how people travelling to work on the train were targeted by groups of freedom fighters and thrown off the trains (while they were moving). They were thrown off because they were seen as supporting the regime by continuing to work for it. I can never forget the shock and horror I felt on seeing this story: a kind of screeching wail that reverberated through me.

    Another was a news report about a small group of people who had been necklaced (https://en.wikipedia.org/wiki/Necklacing) by a group of fighters (who were associated with a soccer club). They had been tortured and killed because they were suspected of being spies, of having dual allegiances. I still cry about this today. It shakes me to my core. And I feel that perhaps I am the “witness” that this event needs.

    ~~~

    Thank you for your posts.
    what can I say? ......really thought that I was walking a line here, as always you are too kind to me. The compulsion to witness? ....oh yes. I get that. I really do. Darkness needs to be stood up to - if not it will cover us all. I might need to row this back a bit before I lose everyone now - most folks will be having me as a real life doomsday salesman - I am not. Sometimes tho' it just gets overwhelming. Thank you for your tolerance.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    diteras, your post touched me because it is so profound. Welcome to the club. You haven't lost me and I'll bet you have been understood by quite a few. I'll bet your shoulder blades (wings) are prominent.
    "The only true currency in this bankrupt world is what we share with someone when we are uncool." From the movie "Almost Famous""l "Let yourself stand cool and composed before a million universes." Walt Whitman

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Diteras,

    Thank you for all of your profoundly moving writing. You are talented and compassionate. And thanks too for your thoughts on thyroid medication.

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    Default Re: Independent Nurse Practitioner's straight scoop on medicines

    Quote Posted by Ayt (here)
    I have found that most of the medical professionals I encounter actually get a bit annoyed when they have you write down all the prescription meds you are on, and you have 0 to list; like either you are lying, or in denial about your health or something. It gets worse the older you get, too.
    I think that is quite a shrewd observation. I once said to someone in clinic who was considering anti dementia meds that - because they had no medication history (not quite as rare as you might think but a bit of a novelty) that it was akin to being a bank manager having someone apply for a loan with no credit history - in other words it is all a bit of a shout in the dark as to what might happen when and if you start messing with their brain chemistry.

    I (obviously) have an interest in hearing alternative explanations for most everything - but this does not mean that the received info is always completely wrong --- It is the proportion or the balance of reasonable levels of treatment which is shades of black. What the answer is I do not know -- in my opinion the following factors are worthy of consideration-

    1 everyone is different - but certain factors can be possible predictors such as family history of cardiac issues. What you need to consider is your level of risk against the NNT - numbers needed to treat when you are offered a drug. This NNT reference (on statins) is short but quite illuminating, (1)

    2 the causes of hypertension are multiple (2) but the best approach, before you take medication (which I am not against) would be to quietly look at everything you can do to modify the condition - either before the treatment starts, or alongside it -- ''lifestyle'' covering diet, (especially salt consumption) booze, fags, exercise, stress reduction - but don't set the bar too high -- and if the BP is dangerously high get it down quickly however you can. That is where meds can be a life saver. The analogy that suits the scenario best is thinking of them as a life-boat -- very required in certain circumstances but not necessarily somewhere you would want to live in.

    3 ask questions of the prescriber -- if they cant tell you how a medication works then I would say they are incompetent - it is a requirement. For e.g the meds Mr Gorman was taking are commonly known as an ACE inhibitor which simply work by stopping your blood vessels constricting. This by blocking the action of the endogenous substance which does this (angiotensin II) -- I say ''simply'' but the full specific product characteristics (SPC) and patient info leaflet are here..(3) ..please look at that link just to give yourself a taste of what is attached to every drug in pharmacy in terms of side effects potential contra-indications and possible interactions-- it blows ones mind does it not?

    4 remember it is your body. It is your life -- don't say no on a point of principle -try to understand all of the factors and actors in this play-- that we are being pressured into taking medication is a fact-- it is all connected Even in an (seemingly) unconnected matter like acquired hypertension it isn't hard to see the politics of human control at work
    ... flow chart to the sausage factory of life like this------- scared/confused ---- confirmed and re-enforced by media and constant reminders in every area of existence --- unhappiness/ ennui ---- so need money/good food /booze/''any other trapping of luxury and stuff'' to take away the pain--- have health and beauty as an icon --- no higher values encouraged- materialism is smart and is all---- in denial of mortality----then have to start paying the price for the dysfunctional things we do to exist in this dysfunctional society ----- bingo! --this is where the pharmaceuticals come charging into our lives- making a little or big problem a matter for them and overwhelming us with the fear-of illness and offering us a few extra breaths---scared/confused

    so be aware of what you do - and remember there is no profit in a cure....treatment ....a different thing eh?


    1 https://www.bmj.com/content/348/bmj.g3458/rr/761453
    2 https://www.bhf.org.uk/informationsu...blood-pressure
    3 https://www.medicines.org.uk/emc/product/6224/smpc
    Last edited by diteras; 27th July 2019 at 10:24.

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