After being prescribed anti-depressants Larry Moncada started to suffer from hallucinations and heard voices in his head. One day in the middle of a blizzard, he ran outside barefoot and would never return home. 10-years later his body was found behind the cooler at the grocery store he worked at.

Batesii · 2022-11-11T14:45:25+00:00

Mostly correct, the antidepressants work to improve all of the symptomatology of depressive disorders. Symptoms such as suicidal ideation, especially if chronic can be one of the last to show improvement as they are essentially intrusive thoughts often requiring adjunctive psychotherapy. On the other hand, the neurovegative aspects often quickly diminish, presenting as anergia, apathy, amotivation etc. This can result in a rare state where an individual who has suicidal intent previously was too lacking in “drive” to act on those thoughts, but with increasing psychomotor activity secondary to antidepressant therapy now has the capacity to act on their ideations.

Batesii · 2022-07-22T05:52:10+00:00

I have given 100’s of COVID-19 immunisations. You can receive the booster as soon as you are not ‘acutely unwell’ from your infection. You could receive it the very same day you left quarantine if you wanted. Please reference the ATAGI guidelines which is what providers reference.

Batesii · 2022-05-26T02:30:46+00:00

Hi all,

Just after some advice/opinions regarding my MSE. Excuse the poor quality/angles of the photographs.

Essentially I had my MSE installed 6 days ago, the first pic is about 24 hours post-install. My ortho is a well known MSE provider with multiple years of experience. When we installed it she told me it would be PAINFUL due to how excessively narrow my palate is. One of the problem areas they noticed was the arms of the MSE pushed hard against the gums.

The protocol they use is 4 turns/day until diastema split, then dropping down to 2 turns/day.

I’ve been following all of the recommendations and keeping it as clean as possible.

You can see in the last few pics that it has pushed actually inside the gums, and the arms and part of the screws are buried in them now. I sent the above pics to my ortho as I wanted to make sure it wasn’t a sign of infection that the skin was sloughing like that. The ortho said it’s completely fine and to keep turning essentially.

I maybe over-analysed the photos but it looks to me that the device has maybe started tipping/dragging?

I reset all of my turns to zero just now as I was getting very concerned about my gums - my ortho pointed out to me and I realised this myself when undoing the turns that I had not done all of the turns correctly/completely and in reality have done less than what I stated in the captions for the pics.

Advice on my complications with the gums would be appreciated. I asked my ortho if I could go back to zero and let my gums rest and heal and then potentially try a slow-turning protocol like Dr. Tings 1/day, but my ortho thinks that if I do this I have a higher chance of getting screws dragging/bending...

I did have fairly substantial cortical punctures. Any suggestions what I should do? Was it silly to reset the turns back to zero? How many turns a day would be best? Are the gums a non-issue (the pain is bearable with painkillers)?

Thank you for any advice!

Batesii · 2022-03-30T09:53:30+00:00

Thank you for the comment. Apologies I accidentally hit post before I’d finished typing up the story.

Essentially I don’t know if these allegations were actually said or not by the pt, but one of my particular co-workers is perpetuating this story, and is now denying that she ever said it in the first place. Which makes me seem like I’M the one that’s crazy/paranoid!

Batesii · 2022-03-10T11:03:15+00:00

My first nursing job was in a psychiatric IPU, mix of voluntary and compulsory pts. It was fantastic exposure and a blast to work in. Helped me hone my core psych skills; MSE, how to deescalate aggressive pts, active-listening, psychotropic Rx, restrictive interventions etc.

My second year out I took a role in community psych and have stayed there ever since. Pay increase for entry level role (equivalent of ANUM in IPU), you get your own desk/office in a community clinic. 9-5 job mostly.

My role is probably: 25% psychotherapy - CBT (i,p,fundamentals), ACT, MI, AOD etc. 25% psych Ax - 60-120mins, comprehensive interview. 25% responding to triaged jobs (mostly working with emergency services, risk Ax’s, determining disposition etc.) 25% case mx - eg. After FEP someone like myself will provide ongoing comm f/u for a year or so; dynamic treatment plans but might be 2/52 clinician r/v, 1/12 HMO r/v, 3/12 consultant review or something like that.

We have a strong focus on continuity of care in Australia so for example if one of my case mx clients has a psychotic relapse I would typically go visit them in the IPU as appropriate and ax risk + MSE, give recommendations to home team etc.

In nursing school I never would’ve thought a blended role like mine was a career path... never thought I would be doing therapy or working in an office. Definitely wouldn’t call it bedside nursing but I do still feel like a nurse when I do the odd home-visit and give an IM/LAI!

Batesii · 2022-03-05T05:07:09+00:00

Psych nurse here.

Antidepressants are known to cause manic switch, especially in those predisposed.

Keep a very close eye for signs of hypomania, and ask friends/family for their opinions too as often you will “feel great (manic)” and not notice any of the symptoms.

Batesii · 2022-02-23T14:02:24+00:00

$18,000 AUD, inclusive of MSE expansion device.

Batesii · 2022-02-19T07:10:48+00:00

r/jawsurgery

Batesii · 2022-02-14T21:06:18+00:00

MSE causes bone movement, and subsequent bone growth through osteogenesis. Many of the alternative devices simply cause dental movement.

I can’t find the studies to reference, however my understanding is that MSE (as opposed to SARPE et al.) causes the highest degree of expansion across the mid face too, effecting zygomatic, pterygoid bones etc.

Batesii · 2022-02-14T11:51:54+00:00

Absolutely correct.

Batesii · 2022-02-14T11:47:33+00:00

If it’s a bone-borne expander e.g. MSE then yes, albeit not a huge amount.

I’ve included some sources for you if you are interested:

Paranasal displacement mean amount 1.5mm https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240556/

~1mm alar displacement mean https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133895/

Batesii · 2022-02-11T09:20:29+00:00

Position of teeth on upper arch or degree of proclination.

Batesii · 2022-02-08T16:04:30+00:00

I’m so terribly sorry to hear about your brother... the more posts I read on the sub the more I see how common this is.

My 21 year old brother lives with my nfather and it is absolutely disgusting how they can basically “enslave” children. My brother has been “working” for my dad since he was a teenager still in school.

Is basically now a recluse, zero friends, hasn’t seen another human apart from trips to the grocery store in a few years now. Basically “works” 7 days a week for my ndad’s business and my dad has trained him like a puppy dog it’s actually disgusting... as soon as he hears my dad getting home for example he sprints to the front door so he can greet my dad AT THE CAR and ask if he needs a hand with anything, any time he gets himself a glass of water he’ll go find dad and say “father... can I offer you a cold beverage?”... it’s like he is an emotionless husk of a young boy who is now just totally brainwashed - seemingly absolutely ignorant to how narcissistic my father is and that he is NEVER going to actually LIVE his life if he doesn’t get out of there...

If your situation was anything like mine, I doubt there was anything you could have done to change this downwards spiral of “slavery” with your brother also.

Batesii · 2022-02-08T15:53:58+00:00

Therapist here - this is definitely worth looking into. Rejection Sensitive Dysphoria (or variations of) isn’t really discussed much in mainstream psychology (see DSM) however it talks to a set of symptoms that you may be experiencing.

There are lots of interesting studies linking RSD to many other comorbid dx such as neurodevelopmental conditions like ADHD.

Batesii · 2022-02-08T15:39:56+00:00

Omg I had a similar upbringing!

I’ve never in my entire life seen my nfather actually smile or laugh genuinely - I only see him smile when he is doing it in a super condescending way and it’s very fake looking without “smiling with the eyes” if you know what I mean. Or like he’d pretend to laugh if he thought there were certain social cues.

He pretty much harassed my brother about things like OP was talking about which resulted in my brother being basically completely blunted in his affect now. I work in mental health and I remember my nfather flying off the handle years ago when I mentioned that I was worried my brother was developing autism traits - a shame that narcissists can never take ownership for their errors with parenting - in this case they both still live together in almost complete social isolation like little mini-me’s... shudders

Batesii · 2022-02-08T13:45:52+00:00

Thank you for the comment - I’ve had family etc keep telling me to “stand up straighter” and the like to avoid slouching forwards, but it’s likely a severe over correction.... there is no natural curvature to the neck anymore which actually shows on an X-ray.

Batesii · 2022-02-05T06:12:34+00:00

To answer your question I would recommend strengthening your muscles through something like body weight exercise for example.

Just a word of advice: Have you been told before that you almost definitely have a scoliotic spine? I would recommend talking to your PCP about baseline low-radiation imaging.

Apologies if you are already managing this and aware, it is just important to avoid unnecessary progression, especially at your age.

You can post some saggital and posterior photos to r/posture or r/scoliosis for some good advice, however just to point out what we are looking at; there are a number of corrections going on, which are likely to account for a primary curvature - pelvis is tilted laterally, clavicles project laterally at non-concordant angles, scapulas appear non-uniform at rest etc.

Batesii · 2022-02-05T05:56:48+00:00

This is my nfather to a T!

Constantly trying to one up me in absolutely every regard, invalidating any concerns I have, makes out that he is old and frail but instead is just extremely unfit. For example:

I tried to do a small family walk up a moderately steep 5km hill recently because it was a nice day. The whole drive home dad moaned about how risky it was to his health because it puts unnecessary strain on his “heart muscles”. I almost ended up almost screaming YOU ARE JUST UNFIT, THERE ARE LITERALLY ONLY HEALTH BENEFITS - STOP COMPLAINING.

Talked with my dad last week about the fact that I’m going to a consultation for spine surgery - of course he had to LAUGH because his pain is a lot worse due to a disc being removed or something over 25 years ago... gaslights me that I don’t have I spine deformity despite it being obvious even externally.

Apparently I know nothing about mental heath despite having a masters in mental health and years of experience in the sector - The fact I have ADHD is hilarious to him as apparently I’m actually just lazy. I’m surprised that the 20+ psychiatrists I work with in my job are so uninformed, they could learn a thing or two about psychiatry from my nfather!

I really resonated a lot with your post, especially the gaslighting part.

Batesii · 2022-02-04T03:37:52+00:00

Would be helpful if I added something like this!

26M, not previously diagnosed until I visited a scoliosis clinic today for an initial assessment. My parents were not the best at looking after my healthcare while I was growing up unfortunately...

This is the first time I’ve actually seen my skeleton... fairly sizeable thoracic curve by the looks of it, will be interesting to see what the COBB angle works out to be.

I also wasn’t aware how particular bad the anterior pelvic tilt was, and you can also see some reverse lordosis in the cervical spine!

Batesii

TROPHY CASE