A story from a type 1 diabetic:

I had what we will call “an incident” where I took pretty close to this scale of extra insulin. I’m a much heavier insulin user but it varies greatly between people and the kind of person who is dosing fractions of a unit like 0.15 turning into 15 would be a massive problem. It took about an hour for me to get to the hospital and I seemed just fine at that point. I don’t know why because usually the type of insulin I use hits it’s peak within an hour for me. My only guess is that my body was overwhelmed and somehow delayed my reaction to it, which I’ve never seen before.

I got into the ER and they were very casual about it. From my past experience in medicine I’m guessing they weren’t sure if it really happened and wanted to see how it played out. My blood sugar was somewhere around 100 when they first tested me. 5 minutes later it was in the 40s. At that point the nurse said “oh fuck!” and sprinted to grab D50 (basically a sugar infusion) from where they keep their meds. I have been a paramedic (not just an EMT) and I can count the number of times I’ve seen a nurse run on my fingers.

They started an IV in both arms and were pumping sugar in to keep me alive. My memory gets kinda hazy after that. They kept checking my blood for potassium levels because burning through that much insulin + glucose uses it up and can stop your heart. Eventually they had to start a central line (like an IV but straight into your heart) in my neck to deliver insulin because they were worried all the sugar they were giving in both arms would burn my arm veins. I remember the feeling when they started it and used a probe to see if it was in the right place the “tickling” feeling literally in my heart. I ended up in the ICU on 1-to-1 with a nurse because they had to monitor me so closely. If I had been later to the ER by 10-15 minutes I wouldn’t be telling you this story. I also had the benefit of knowing what happened ahead of time, which you would not if your pump magically multiplied your dose by 100 and you didn’t notice.

All this to say, this is pretty fucking serious.

Oh, fuck. This would have been nice to know sooner.

White House fireplaces

One of my favorite West Wing episodes

Mr. President, you know how you told me not to wake you unless the building is on fire?

I look at you and see a person. A person who doesn’t deserve the critical words that you’re writing about yourself. I don’t feel comfortable as a cis man coming into this space and telling someone whether they pass so I won’t (that doesn’t mean I don’t think you do!). But the only person who defines who you are is you.

Are you transitioning so that the republicans might be right about something? Therapy, medications, all sorts of thoughts and emotions, changing your body… I didn’t think so. Anyone who assumes as much by simply looking at you isn’t worth my time, and I hope they’re not worth yours either.

Remember, everyone only has so much control over their own appearance, it only represents what’s inside as much as it will let us. The rest has to be made up for by acceptance. You’re so not alone there.

Look around at these comments… You have people from all over the internet telling you directly or indirectly the same thing. Be who you are. For yourself. Or you’ll never be happy.

Where I live that might actually be a good deal on the cigarettes. Haven’t bought one in a while though so I’m not sure.

Put it in a code block (it’s in a quote block now, use ``` on both ends instead) to preserve newlines or add at least 4 spaces at the end of the line to force a newline.

Test to make
sure I'm correct

Test to make
sure I’m correct

I prefer to call it the generation formerly known as Twitter

I read this in Arnold’s voice

Yeah it was really weird earlier when I first found it and I saw detailed scientific discussion and then someone said they were “bullish”. I imagine it would be like seeing a centaur in person for the first time.

Sorry, I’m getting tired so this response won’t be as complete as I would like. Disclaimer: all of this is based on my own experience and I don’t know how much others differ.

Ketamine was great. I’ve been around the mental health world quite a bit in the past few years and tried all sorts of treatments, and one of the things that surprised me when I started ketamine was how much they let you flounder with less effective stuff before doing ketamine. I remember reading the wiki article on it and the success rate was incredibly high compared to other things I’d tried before.

In case you’re going in expecting to have a mild experience like with most medications, don’t. The first session at the reduced dose I mentally was in another dimension. It’s not uncomfortable or scary, it’s just also not subtle by any definition. It wears off quickly, for me almost always within 45 minutes if I slept the night before, and those 45 minutes never felt way longer. My tolerance built up quickly and twice a week for the first month ended up with less impactful sessions than when I went down to once a week. If I skipped a week or two the next session was pretty much back at full strength.

The goal is to wake up some of your neural pathways you’ve neglected to use while depressed. Think of it as hiking trails through a forest that have become overgrown so you stick to the comfortable, well-travelled ones (depression). What this means for what you might experience is the awakening of some of your demons so you can confront them and leave them behind. The good thing is that they’re not scary in the moment, but you likely will come out of some more intense sessions feeling some ways about stuff. After the whole thing I would say definitely worth it, and I’m the “avoid anything even slightly unpleasant at all costs” type. ETA: I also had a lot of “epiphanies” about stuff I already knew that helped me see reality in a different way. For example, I already knew that most of my issues were situational, but through these sessions I realized that if a problem is from something outside of myself, that means it’s not evidence that there’s something wrong with me. I know it sounds silly when written out, but those are the types of revalations I had and that specific one has been one of the strongest tools I’ve had since then.

Ketamine was the last treatment I did for my depression, a rather severe case with one of the episodes lasting a few years and a serious suicide attempt. Depression is no longer on the list of things I feel the need to actively work on (apart from small maintenance to my thoughts) and I’ve discontinued all of my depression meds that I was relying on before that.

There’s a bot here for that… I just don’t remember how to use it.

It’s very similar but it’s not the exact same (not including the time release part). Vyvanse is 100% dextroamphetamine after time release; adderall is 3/4 dextro and 1/4 levoamphetamine. Different people feel that differently, for example with only dextro I feel much calmer/less prone to anxiety, but without the small amount of levo I have trouble motivating myself and can fall asleep easily. They also have 100% dextro in instant release format: dexedrine or zenzedi.

That makes a lot more sense. I dunno how I didn’t see it

No kidding, I stared at it for a minute going “is this going to set it off?” and when my brain finally decided it couldn’t come up with an explanation it launched hard into the skin crawling, scalp itching and nausea. It’s like visual kryptonite.

You should make this it’s own post. This is epic.

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I read hippos as hippies and was thoroughly confused by the time I read the whole thing

🤷 Maybe it was a super leap year

On the 83rd day of January in 1942?

That’s really not true about ADHD. It’s very poorly named. Leaving projects unfinished after a month or whatever is a very common ADHD behavior. People with ADHD don’t have a deficit of attention, when they’re interested in something that is all they focus on (called hyperfocus). And fantasizing about wanting to do something and not being able to get yourself to do it is another very common thing with ADHD.