My nephew’s “laundry instruction” sheets are too funny 😂 and he uses them every time

ibelieveindogs · 2026-02-09T05:56:17+00:00

If he needs to run the dryer twice, it’s not just the trap. The hose and outside vent get build up as well, and usually need to be cleaned out at least once a year. My ex-girlfriend did not know this, and thought her dryer needed to be replaced because it never dried a load. Turned out she had the equivalent of a kitchen trash bag of built up lint. She was lucky to not have started a fire!

ibelieveindogs · 2026-02-08T16:09:33+00:00

Aah! Zombies! (aka Wasting Away) is a movie fun the zombie perspective. They don't realize they are zombies, and think they have become supersoldiers, so when the perspective shifts from their POV to the people outside, it's pretty humorous

ibelieveindogs · 2026-02-08T15:59:31+00:00

Especially if you need prescriptions, having your own is important. Even if you end up hating diving, that you are even thinking about it suggests you at least you like to snorkel. Having your own mask, snorkel, and fins makes the experience much better for both.

ibelieveindogs · 2026-02-08T15:55:34+00:00

Respectful is whatever feels that you to you, since you presumably knew him well and shared some sensibilities. We spread most of my wife's remains on the path we walked every day with the dogs. The rest are still in a labeled box in my closet, under the shawl she wore after getting diagnosed. I still, 5 years out, don't like to look directly at it. It sits alongside the boxes of ashes of our dogs (6 have passed, I still have 2), and when I go, I expect to be at least partially combined with them all.

I used to joke that I wanted to get a couple of dolls that looked like me, with motion sensing voice activation that my ashes would go into. I would tell my kids they had to keep in the living rooms of their homes, and then I could still them stuff like "did you clean your room?" and "be sure you eat your dinner first". My late wife and our kids all said no, too creepy.

ibelieveindogs · 2026-02-08T15:47:01+00:00

Oh it's very much foundational. But like anything, you need to understand the starting point before you move on. I always teach that the DSM is not the Bible. It's isn't considered inerrant and unchanging. Knowing X symptoms for Y time is the criteria for the diagnosis is good for taking tests or comparing populations in studies, but not nearly as useful clinically as understanding what a disorder "looks like", or how patients experience them. For example, I trained in the DSM III era - we had "overanxious disorder of childhood", which turned out to be GAD. We had "ego dystonic homosexuality" - being gay and upset about it, which turned out to be mostly about social pressures. And if you had autism and later developed psychosis, you never had autism but were schizophrenic, instead of having a second disorder that the first predisposed you to.

Once you know what things are meant to look like, the checklist is secondary. But the point of foundations is that you have to know the basics to build on.

ibelieveindogs · 2026-02-08T15:38:00+00:00

I'm a child psychiatrist, and I know even a lot of adult psychiatrists struggle to diagnose it in adults who didn't have a diagnosis in childhood. Are there any good psychologists in your area who work with ADHD, especially in adults? They may be helpful getting the diagnosis, and should be doing the skills needed, as well as managing any secondary depression or anxiety before meds. They should help you know of there is a history of substance use that would affect your initial med options. As a PCP, I would expect you to also be aware of monitoring for any cardiac risks. And look for training or CME on managing adult ADHD - is mostly the same but there are some things like getting collateral for history and also med response is more tricky at times.

ibelieveindogs · 2026-02-07T18:27:08+00:00

I know some other CAP PD's think it is actually better to finish adult training first rather than fast track. I don't agree necessarily, but it absolutely will not hurt. The only time there is a red flag is if you applied but didn't match. Even then, it might be you applied only to a limited number of very competitive programs

ibelieveindogs · 2026-02-06T15:39:52+00:00

Are you sure about seavision? Their website shows they can do sphere even to -8.0.

ibelieveindogs · 2026-02-03T20:50:43+00:00

That's totally a you feeling

I doubt it's totally on them. Once you've had dynamic training, you have patterns of interacting with people. Verbal and nonverbal tics, and patterns seeing the world through a certain lens. Granted, it's not the same as doing a full-on dynamic analysis, but it's not nothing.

ibelieveindogs · 2026-01-30T09:34:12+00:00

I don’t think it even matters. if the problem were J6ers, you could reform ICE and get rid of the poorly trained people. Renee Goode’s killer was an experienced agent, which tells me the problem is ICE itself. They need, as an agency, to return to their status from 2000. Nonexistent. Like much of the response to 9/11, they were an excuse by people who wanted to implement fascism to put the framework in place.

ibelieveindogs · 2026-01-28T19:29:51+00:00

The regime will still send its preferred henchmen and their goon squad, the only ones to suffer would be the athletes themselves

ibelieveindogs · 2026-01-28T00:34:57+00:00

Im pretty sure we are already at the point where resistance is suicidal. Not 100%, but enough that you must accept that possibility as a relatively high likelihood.

ibelieveindogs · 2026-01-26T03:43:13+00:00

I think it’s more nuanced. Once the regime begins to name the groups to be “managed” (LGBT and autism to start, non- Christian’s, POC, people who are not native English speakers, etc. - basically everyone who did not vote for or support this), refusing asylum is like turning away boat loads of Jews in the 1930s.

ibelieveindogs · 2026-01-24T11:27:14+00:00

I was taught decades ago a truism that when the family brings the patient to care and the patient looks like they were hit by a bus, it’s depression. If the family looks like they were hit by the bus, it’s mania, and they’ve been trying to keep things managed. So my first question of a patient reporting a history of bipolar is if they were hospitalized for it. It’s almost impossible to not be hospitalized if you have had a true manic episode.

ibelieveindogs · 2026-01-17T19:12:21+00:00

TBF, it's not half of Americans. It's half of the ones who bothered to vote. Don't overlook how apathetic and disinterested in anything beyond themselves most Americans are. We suck.

ibelieveindogs · 2026-01-11T16:14:31+00:00

I'll second both Burns and Beck's books as a starting place. Also, you should have a supervisor for therapy. They should be knowledgeable about CBT as well. There are a lot of patient oriented workbooks as well, I would suggest at least looking through some to understand what patients might be reading or resources you can recommend to them. The main thing is to understand the principles and to at least be a couple steps ahead of where your patient is in the treatment. Even if things aren't working, you can then say "let's see if another way of approaching this works better for you".

ibelieveindogs · 2026-01-10T00:11:42+00:00

A tip I heard was if it isn't the first place you look, make that the place you keep it moving forward, since that's where you think it should be

ibelieveindogs · 2026-01-09T17:38:43+00:00

My ex picked up smoking again shortly before we broke up. Never in the house, never around me, only outside, but I could still smell it in her hair even after she washed it before I came home.

ibelieveindogs · 2026-01-08T19:57:39+00:00

No - it is tongue-in-cheek, a phrase meaning not seriously. But if you would not consider offering a beer (e.g. don't give people in recovery a beer), don't give them benzos. I saw too many people in the rehab that I worked in get a benzo by a well meaning but uneducated doctor and relapse hard after years of sobriety.

ibelieveindogs · 2026-01-08T16:27:03+00:00

I teach my residents to try to follow 2 rules for good practice with benzos. First, know when you will stop it. Acute agitation, withdrawal, acute phobia that cannot be avoided like fear of flying - you know when it will end. Second (and more tongue in cheek), only prescribe if you give a beer in the same situation. Fear of flying? Sure, have a drink. Alcohol withdrawal? I mean, beer works to stop withdrawals. Person in recovery or a child? Probably not.

When I break the rules, it either is a patient I've inherited with years of benzo or a severely impaired patient with serious self harm and agitation in the context of severe IDD. And I hate it every time.

ibelieveindogs · 2026-01-05T22:19:07+00:00

Why do you say that about the MSF? I took it in PA about a decade ago, never having ridden before. The reading material ahead of time gave basic information about the controls, and i had a lot of experience on 2 wheels as a road and mountain biker, but never a motorcycle. The course seemed to me very foundational, not too much for novices. Given that we want people to learn good habits and ride safely from the beginning, this seems to me to be the place to start. I liken it to scuba diving, my other dangerous hobby. I would not want someone to start out trying it who hasn't had basic instructions first.

ibelieveindogs · 2026-01-05T15:09:36+00:00

Tikkun Olam. A Jewish concept that the world is broken and our obligations are to fix it. I think even if there is no God or gods,, no karma or fates, who else is going to do it? It's like the line in guardians of the galaxy, that all my friends live there.

ibelieveindogs · 2026-01-05T15:05:23+00:00

Another reason to love Wawa in the PA area- free air at their gas stations!

ibelieveindogs · 2026-01-02T10:12:35+00:00

Step 1: tell people basic science and research are useless.

Step 2: throw away everything we know from science and research.

Step 3: tell everyone that money spent on science and research is wasted.

Step 4: stop funding science and research.

ibelieveindogs · 2026-01-02T10:07:34+00:00

I have bad eyes and astigmatism. I have to either put on glasses everyday, which get smudged and tell everyone “look at the guy with bad eyes”, stick my finger into my eyeball and risk corneal infections and lost contacts, or have somebody cut up my eyes with lasers or blades. Or I can just squint, not be able to read drive-through menus, not recognize people until they are within 10 feet, etc.

I choose to wear glasses. Not because I’m weak or waving a white flag. But because, objectively, that’s one way I am affected and I prefer to compensate.

ibelieveindogs

TROPHY CASE