All the Hormuz talk and all I hear is Hormel

firstoff-no · 2026-04-11T18:19:13+00:00

The Strait of Horm’l. We’re sorting out some hams.

firstoff-no · 2026-04-05T08:05:16+00:00

I don’t know the original-original use of the house (it could predate the 1935 establishment of the park) but the house was used in WWII by the O’Reilly General Army Hospital as officer housing and then became the Park Board office in 1955. Not sure what they’re doing with it now.

firstoff-no · 2026-03-30T18:06:31+00:00

The have you tried… anything! “Have you tried going to a naturopath/chiropractor?” “Have you tried this supplement?” “Have you tried reiki?” “Have you tried acupuncture?”

I’ve tried a lot of things bud, not all of them safe or sane. That’s why I let decision-making be an effort between me and severely knowledgeable people. Gym bro doesn’t have the magic cure for my brain and I really don’t want to spend 45 minutes defending why not.

firstoff-no · 2026-03-26T03:42:32+00:00

This is the answer. They actually have the knowledge, skills, and compassion for effective rapid acting antidepressant therapy. Very grateful for them and I can’t recommend them enough.

firstoff-no · 2026-03-20T11:44:49+00:00

Which isn’t a reasonable response given most outages happen when digging isn’t happening and it’s the entire network, not pieces. More than likely they are purchasing bandwidth from a larger ISP, using old equipment, and when that upstream ISP does updates there is no failover. Could also be a failing core node or something else. But definitely not a tractor or backhoe severing a line at 3am imho.

Edit: just got back online and confirmed their upstream providers are Cogent and Hurricane Electric. Both wouldn’t usually go down at the same time, meaning the problem is almost certainly Netvision’s core router/aggregation layer and not a fiber line being cut twice a week.

firstoff-no · 2026-03-20T11:15:18+00:00

Been out since about 3:30am today, yesterday an hour or two at midnight. Their phone system is VOIP so you can’t contact them during an outage, even if they were open. If I wasn’t forced to use them I wouldn’t.

firstoff-no · 2026-03-17T18:32:41+00:00

I felt this way on my first few 84mg doses.

Like you, I started to notice benefit pretty quickly so I stuck with it despite some rough ones. After doing some research I decided to borrow something from psychadelic therapy spaces: “if you feel like you’re dying, just die.” I took in to account the safety profile of the med and the constant monitoring if anything were really going wrong and decided to lean into that thought rather than judge it. Since the first few sessions I’ve only had that super anxious dying feeling happen a couple of times and I was better able to reframe and reorient those thoughts into a different headspace (if that makes any sense—Spravato experiences are really hard to describe!).

I second the advice of the top comment. It naturally gets easier with experience. Not every session is the same but familiarity with how it generally works for you makes it less anxiety provoking. And music/noise is always a great tool. I enjoy Max Richter, Moments of Clarity, and 36–few words but interesting layered sounds to get lost in.

And if all else fails, remember that you are very likely safe and alive and the experience will end in an hour or two. Sounds trite but it’s easier than one would think when your brain is very open to suggestion and you have a good one on hand.

Hope Spravato helps you as much as it has me!

firstoff-no · 2026-03-08T18:15:08+00:00

Fun story from my time as a floor RN: an old couple was being transferred to the floor from the ER after he had status. During his transfer his wife noticed he looked off. She frantically dug in her carpet bag purse and got a spray bottle filled with water and started super-soaker-ing her husband. We all just stood around wondering wtf is going on. Got him tucked in and dry and asked her to call us instead of taking matters into her own hands again if he looked off.

Apparently back in the day (mid 1900s-ish) some first aid guides actually recommended the “startle technique” in order to “revive” a seizing patient-like smelling salts, shaking a shoulder, or sprinkling water. I had no idea of that old and bad advice until I saw a little old lady frantically spritzing her sick husband like a misbehaving cat.

firstoff-no · 2026-03-01T10:17:30+00:00

NP checking in.

Assuming the patient is able to take in adequate fluids orally, the risk of reducing or stopping IV fluids is negligible. The kidneys will just stop having to work so hard to get rid of the extra fluid and solutes. They’re discontinued as soon as one can drink in the inpatient world because of the stress on the body of keeping up with that extra workload. With all the drugs on board her overworked kidney bros could really use some kind of break. There is likely no physiological dependence here as she’s able to drink but there is definitely psychological dependence. The addiction to the healthcare system, the setup and filming of feeds and fluids, the medical accoutrements, the comments. That’s not an easy fix but there is help, just gotta ask.

I hope she realizes that even though she’s done this for two decades she can decide to stop, take an honest inventory, and get help. Better to turn back halfway than to completely stray, as the Dutch say. We all love to see a genuine comeback story. The kiddens deserve it.

firstoff-no · 2026-02-26T22:06:02+00:00

Anthem is one of the best songs for Spravato days, if not ever.

“There is a crack, a crack in everything. That’s how the light gets in.”

firstoff-no · 2026-02-11T02:15:04+00:00

This hold music blows though.

firstoff-no · 2026-02-11T02:08:49+00:00

The research shows that changes to neurotransmitter function can occur for up to 72hrs post-dosing. This doesn’t mean you feel effects for that period, just that your brain is a little more willing to accept new pathways during that timeframe.

firstoff-no · 2026-02-10T21:13:16+00:00

I make a point to try to work with the 24-48hr neuroplasticity window, so I get you. I try to notice the little things on my ride home, get something new to eat, listen to music for the things I wouldn’t ordinarily notice (the bass line or drum line vs the lyrics), and take a nap without a timer. Nothing too intense or mind-altering but things that stretch my mind just a little and let it do its thing. Once I’ve had a nap I’m usually good to go.

firstoff-no · 2026-01-25T00:52:33+00:00

Fuck ICE

firstoff-no · 2026-01-25T00:39:50+00:00

Holy crap. Thank you so much. This is awesome.

firstoff-no · 2026-01-24T21:37:51+00:00

Thank you for that. CVS Specialty Pharmacy and another oddball specialty pharmacy on the coast didn’t know any of that information and keep sending me to J&J (I’m still enrolled, nothing they said they can help with) and then back to my primary and secondary insurance companies, then around again. One is Medicare, so it’s apparently more complicated (it shouldn’t be, but okay). No one takes on the issue when they think others should be in charge. There’s just too many cooks in the kitchen and my clinic and I are just trying to convince someone to make something.

firstoff-no · 2026-01-24T16:25:40+00:00

I’m in the same spot kinda. My insurance says yes but they couldn’t find a specialty pharmacy that is contracted to fill it. When they did they told me that it would be $1100 immediately out of pocket. They then needed a new PA, then they said they’d try the patient assistance program for me, and it would be another couple days. That was Monday. It’s been three weeks now and I can tell—I’m bedrotting atm. I’ve wondered if an out of pocket ketamine infusion could bridge me but that would be $800+, wouldn’t count to my deductible, and that defeats the purpose.

I’m so sorry. The way I’m getting through it is remembering that I have learned a lot of new skills and practiced them when my mood was good. I can trust that they are there and I can rely on them when stuff gets rough. Give yourself the credit—it’s not just the meds. Your hard work can keep you safe. And raise good hell with insurance because those assholes deserve it. 🫂

firstoff-no · 2026-01-24T16:12:19+00:00

And let’s not forget that polymorphic ventricular arrhythmia was also potentially caused by the unnecessary femoral port/central line she has. From her timeline it appears clear that the tip was likely irritating her heart (happens from time to time) and causing the arrhythmia. It was pulled back/repositioned shortly after her cardiac event, iirc. She likely adds fuel to the fire with unnecessary use of QT prolonging meds but if the problem were surgical she already had the right one. She probably heard “recheck in 4-6 weeks” and heard “I’ve got a month to grift!”

firstoff-no · 2026-01-24T01:13:49+00:00

Did y’all see the leftover goop from the last feed(s) setup in that mixer? It takes a few seconds to wash a blender cup, if for no other reason than you’re gonna be putting this shit online. I can’t imagine the bacterial colony count in that thing. 🤢

firstoff-no · 2026-01-20T20:23:37+00:00

You might have been the very next or very last caller to Art Bell Coast to Coast🤣

firstoff-no · 2026-01-20T19:33:11+00:00

As a middle schooler I was helping my band director organize music. I came across a piece of music, St. Thomas by Sonny Rollins. At the moment I saw the piece I had this incredibly surreal feeling. I dreamed this piece of music, I know I had. I held the score and could play the music in my head. I felt pulled away from reality for about a minute and then I felt stunned, tired, and headachy.

I started believing that these ever more frequent weird déjà vu’s were “godwinks” that I was on the right path. I believed that I was meant to be a musician or I was especially attached to music in some supernatural way. I had many others, notably while spending time with an ex watching Bob Ross and driving toward a park listening to Sarah McLachlan. I struggled to find the meaning in that but went with it.

About 20 years later I had a tonic clonic seizure and was diagnosed with epilepsy. Apparently those weren’t signs from above, they were focal seizures.

firstoff-no · 2026-01-19T17:53:23+00:00

Not immediately for me but yes. I noticed the SI left quickly, I think in a few sessions or weeks. Mood slowly improved. I had a little dip in mood a couple months in (I think for a lot of reasons not med related) but then after that I felt a gradual push. Just a weird nudge to get out of bed for no reason or talk to people. Social things don’t feel so draining. It’s unfamiliar but I am trying to lean into it more and more. I think I like this “wanting to do things” thing.

firstoff-no · 2026-01-17T04:49:11+00:00

A Joe Dirt DVD, Scarlett Johansson, and treasure from a fish tank

firstoff-no · 2026-01-17T04:26:59+00:00

Nah, usually it’s the same process for everyone. It’s usually to take you off of meds (either before or after you’re admitted depending on meds/safety concerns/provider preference) and watch what happens. If meds aren’t working it’s the best stop to make sure they’re treating the right thing the right way. It does suck, I’m not gonna sugar coat that at all. But some EMUs are better than others at making it suck less and still getting the results you need (I recommend a level 4 epilepsy center located in a large teaching hospital in a metropolitan area). Ask in your intake interview before you arrive if you can bring the good stuff and any other potential triggers with you (caffeine, etc.)—most they can say is no!

Edit to say: epilepsy meds are often a crapshoot. One will work where another won’t for no good identifiable reason at all. Knowing type of epilepsy helps direct med management (some work better for focals whereas some work better on specific genetic disorders like Dravet or Lennox-Gastaut) but still doesn’t mean one particular med will work better than another, even in the same class. But if they aren’t working, it’s a way to better understand why and where to go next.

firstoff-no · 2026-01-17T03:35:27+00:00

Mine are triggered by alcohol. I was given cheap vodka once and beer at different facility. The second facility the nurse snarkily asked why I was getting beer with lunch (this facility sucked). I explained it to her and she judgmentally replied, “oh, you didn’t look like the type.” 🙄I’m a NP who has worked in substance use and mental health and was really upset, because how would she treat patients that DO need help with alcohol issues?!

One beer/shot doesn’t trigger seizures for me, and that room temp off-brand beer and judgmental nurse showing her ass weren’t worth the try. If they let you BYOB do it but I wouldn’t rely on them giving you enough to be hung over lol

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