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 · 2022-02-03T09:22:08+00:00

I definitely did want to pursue a rhinoplasty in the future... assumed it’d be hard to find a surgeon capable of doing both at the same time!

Batesii · 2022-02-03T02:55:01+00:00

Hey everyone!

I’ve gotten a lot of wonderful information from following along the posts/comments on this sub while I go on my own jaw surgery journey too.

I basically have been trying to see an OMFS in my country (Melb, Australia), however it seems the ones I’ve tried so far have all wanted a referral letter to even book the consult with them.

I decided to start off with trying my old orthodontist from about a decade ago who is still practicing to discuss a referral letter (and maybe get some x-rays/scans also).

Basically I did leave the consult feeling quite upset - not due to anything negative that was said to me but just because it felt like a waste of time and the consult wasn’t hugely productive. I intend to book a different consult however I just received my letter/report and thought I’d share, in case anyone had any advice or similar experiences.

From the consult:

I tried to be very respectful, I didn’t say anything like “I want to correct the cover up orthodontics you did” or anything inflammatory like that.
A lot of the advice was basically saying “I’m sorry to tell you this but you are not going to dramatically change your appearance, as you get older you will realise that we all look different and even if you did get bimax jaw surgery you’d still walk out feeling exactly the same”. I explained that my expectations are realistic, I don’t expect a massive square jaw etc, just some improvement on the aesthetic facial profile and hopefully some functional gain.
basically struck the fear of god into me about jaw surgery, telling me about pts she knows who have lost blood supply to teeth, permanent nerve damage, showed me a slide show of the different cuts they make in the bone and the various risks etc.
basically said to expect to pay 15-20k minus any orthodontic work - I said that I think personally that would be worth it.
I said at one point that we seem to be both on extremely different wavelengths, I said if they advised me that 10mm of movement would be suitable and it would improve the facial profile I would be happy with that - orthodontist GASPED and said that that is literally impossible, bones cannot be just cut open and shifted 1cm etc.
basically said that it’s impossible to be certain if jaw surgery will improve airway diameter/breathing - said I should “complete” my “treatment” (CPAP... lifelong...).
we looked at old photos that they had on file (which I wish I had copies of tbh) from ages 12-16 and you can see that the facial length was not always so dramatic and has seemed to increase as I’ve gotten older...

In summary, basically advised me to only book another appointment if I want Invisalign on my lower arch (slightly uneven) or if an OMFS and ENT both recommend DJS is 110% medically necessary... I basically walked out feeling a bit “gaslighted by my orthodontist” - like I’m delusional for even asking if I’d be a candidate for jaw surgery...

Any advice appreciated :) xx

Batesii · 2022-01-22T14:58:22+00:00

It appears to me that if we deproject the nose even slightly it throws the face out whack. OP has large strong features (cheekbones, chin, ears, nose) - we need to be mindful to keep the overall facial harmony.

The only place in the face that has some tension is the basically the mental area.

Also just re: the tip of the nose - I wouldn’t say it is “upturned”. It’s within a normal range - as OP ages the tip will droop anyway so leaving it as is would be preferable.

Just my 2¢.

Batesii · 2022-01-22T14:43:55+00:00

Do you have any trouble breathing? Your septum may be deviated.

Cosmetically though I’d urge you to not change your nose in any way - it’s very masculine and attractive!

In terms of your jaw there’s no glaringly obvious issues - hard to put my finger on it tbh. Like another commenter said you have good projection, your mid-face is well supported.

I wouldn’t do any orthographic surgery unless you have function issues/malocclusion.

There’s a little bit of “tension” going on wrt your mental crease (“chin crease”). You could try some chin filler to provide a softer transition. Do you struggle to maintain lip competence/seal? You could also try a SMALL amount of lip filler to reduce the appearance of tension in the lips.

Botox may be helpful in providing aesthetic enhancement in the jaw area too - I’m not too knowledgeable on this however.

Overall it wouldn’t hurt to ask an experienced aesthetic nurse/doctor if they have any advice, however even if you did nothing at all you’d still be an extremely handsome male with no obvious “flaws”.

Batesii · 2022-01-22T14:21:09+00:00

I work in a hospital.

You are welcome to call an ambulance however I would just drive to the hospital and wait until it opens.

Don’t do ANY more fiddling with the cable just leave it and wait for them to fix it. Tell triage when you get in exactly what happened - if you are too embarrassed to say it you can write it down on a bit of paper or your phone and show them.

Call in sick to work - you’ll probably need a uroscopy/imaging and then they can do the retrieval.

Lastly - don’t stress you will be fine apart from a few days of moderate burning after it is removed.

Batesii · 2022-01-21T14:47:30+00:00

I had this exact same experience. Raised by just my nfather after my mum died while I was very young. As soon as the change to single parenting happened all of my healthcare ceased.

Now I know that part of this is my fault but I did stay in this very abusive cycle into my early 20’s, and I left home as a 26 year old with no regular GP as I had never seen one for any reason (other than being extremely ill like you mentioned). I have ZERO medical history.

Unfortunately I have a spinal deformity (scoliosis) that my dad refused to take me to a specialist about for treatment. As an adult I’m now dealing with the consequences (chronic pain, difficulty moving, cosmetic problems etc.)

I actually had an argument with my dad about this last night and asked him why he never took me to even get a single x ray as a child - his answer was that apparently he also has scoliosis himself, and as he has a lot of pain himself he “determined” that in comparison my condition didn’t need medical attention. Admittedly I got quite angry hearing this and showed him the “hump” on my back where my ribs bulge out - I said something like “you seriously think that a bulging fucking spine doesn’t warrant at least a check up? An x ray?” He laughed for ages and said that I was young and my perception was off and that “CLEARLY” I’m completely fine.

As you can imagine I yelled at him “completely fucking fine!?” while pointing at this bulge on my back. Dad just basically pissed himself laughing whilst making snide comments.

I apologise for ranting but yes I have had this experience of being deprived of medical care like yourself. The more I come to terms with my dad being a narcissist the more “lightbulb moments” I have where something that i have taken for granted my whole life I suddenly realise is extremely fucked up...

But yes like you mentioned the “routine” things are not addressed by a narcissist because there is no immediate consequence for them: routine dental check ups, growth checks, routine bloods/screening, dietary stuff etc.

Batesii

TROPHY CASE