u/clockworkbuddha

Nice - Penguin Cafe Orchestra vibes circa Union Cafe era

So according to the Mark Hollis biography - what is really counterintuitive (to me as it sounds organic) about Colour of Spring is that they got into using the Fairlight sampler and a lot of the drums/percussion were recordings of Lee sampled and looped. Suspect there’s pitched down samples and as you say possible Simmons or similar in there

Sure they’re random - but if they persist ie carried down generations it suggests a fitness advantage otherwise it would die out. So anything genetic and common - there will be an upside to organisms having it.

But….. cystic fibrosis is when both copies of the gene are different. If just one copy is different it may confer resistance to cholera - one theory as to why CF is so prevalent

Firstly, try not to think of them as ‘idiots’ - our colleagues were quite liberal with antibiotics so our patients have learnt to expect this and you can’t blame them. I just say ‘they won’t work and may increase harm and I don’t want to cause you any harm’ - seems to work in most cases

It’s not about blame - but in any relationship e.g. colleagues, with patients, at home etc - if we’re not being clear about our boundaries from the start then they will be pushed and crossed. Being clear about boundaries doesn’t mean being strict or unkind just very clear. It’s why it seems patients are ‘more demanding’ - the boundaries weren’t made clear. This is stuff that needs to be taught and instilled at the start of training

The medically assisted withdrawal bit is a small part of recovery - but naturally people fixate on it being the solution without thinking about what happens after. It is a very risky process and needs daily monitoring so like everyone says - not for gp. Bloods, thiamine if needed and encouraged to seek mutual aid groups like SMART or AA or similar. DVLA! Really important but often missed. And safeguarding - Re their mental health - if suicidal refer on. Don’t start antidepressants - they won’t work if active substance problems

I think it was left to die….

Must be a relief maybe? Information governance says you have the right to have the correct information kept about you - so you’re in rights to ask anything since adhd diagnosis be amended

Really easy - Kate Bush in ‘14. Fan since teens - anxious if she would deliver. And she did, and then some. Though it was more of a performance than gig - though live band. She really knocked it out the park and has remained top artist show I’ve seen ever since.

What’s the average? Any evidence base you can point me to?

On top of XL dose in morning?

A lot - I have a patient I find attractive and I regularly discuss In supervision to ensure I’m not crossing any boundaries etc. it’s disconcerting noticing you find someone attractive but I feel healthier for being able to discuss In supervision and I think it helps the therapeutic relationship (obviously would never disclose this to my patients!)

The tapering off sertraline 25m-50mg every week or so should be fine. But - wait until absolutely stable on the Vyvanse and discuss with gp before tapering.

👍 thanks for the ama and look after yourself

Well they think dopamine is about wanting not liking and over time the pathways become sensitised to where you really want something but don’t like it as much (tolerance being one reason and repercussions of drug use another) - so end up feeling really compelled to keep using when you don’t want to. Link to a summary here

I’m curious - incentive sensitisation theory says it’s more about wanting than liking the drugs in dependence - not disputing it feels amazing but would you say you want it more than you like it?

NHS Practitioner Health can help you with your mental health - take confidentiality very seriously (notes not kept on NHS spine) and can provide psychological input and support

I gave up - but if I ever get it working again I’ll post back in here

I did briefly then something changed in Plex and the playlists diss appeared so gave up. Pity, it was handy

Working in healthcare I’m aware of the need to differentiate between self appointed experts and actual experts who have demonstrated their expertise through exams and peer reviews. This dr was acting outside of guidance and presenting himself as a self appointed ‘saviour’ so not someone I’d trust or seek advice from. There’s good reason they say only trained people can diagnose and initiate treatment for ADHD

Be careful what you take to your GP 🙂 something majorly wrong of course needs addressing- something slightly off and of doubtful significance they’ll be less interested. Remember we’re quite broken as a service at the moment!

Try not to be your own doctor 😀 if you do any test you have to be asking a specific question and there should be an evidence based plan based on results. No use randomly checking things because if one result slightly off (and there’s always a chance one will be slightly outside normal range as no one exactly the same as someone else). If it’s thirst then as long as blood sugar ok then it’s probably dry mouth causing it as adhd meds definitely do that.

Are you UK? Lots of questions as I’m a UK Dr 😀