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Tuesday, November 29, 2011

Ginger "The Babbler" White versus Herman "The Worman" Cain

This is a dose of help for all the foolish women out there who out their secret lovers.....Stop telling your classified closet capers! Frankly, the rest of us don't want to hear about it. Why can't you keep your personal business to yourself?!? The repeal of Don't Ask Don't Tell does not apply here ladies!

It's just embarrassing for women everywhere. Ginger White and all the accusers coming out of the woodwork like little tattle-tale rats... it's nauseating.

Whose character should we attack? Hers or His??? Or should it matter at all? Seems to me these ladies are telling stories because they want something.

Ginger, why didn't you go to confession instead of the media? Ginger, why are you ruining your reputation and bringing all us gals down? Ginger, you chose to be with the man for crying out loud! And I'm not sure I believe you anyway!

Ladies....boudoir antics must never verbally stray from the bedroom! No videos either! Don't kiss and tell!

Word of the day: Uncouth.
Definition: lacking in polish and grace, awkward and uncultivated in appearance, manner, or behavior. Rude. Boorish. Classless.
Sentence: I found the woman rather uncouth; indeed, she was quite an unsavory character.

Thursday, November 24, 2011

Thanksgiving and Our Obsession with Balloons

Now don't get me wrong....I'm all thankful today, but I can't help pointing out that Thanksgiving is like the high holy day for balloon lovers. I'm talking about the Macy's Thanksgiving Day Parade! It's even on TV! And Miss America is in it too! But it's about the balloons...big big big balloons of spiderman, spongebob, and every thing that makes America fun!

Historically, Thanksgiving is about Europeans who came to this land and ate turkey with the natives to celebrate and give thanks for a good harvest.

More recent American History shows us it's really about balloons! Gloriously big balloons! So here is a reminder of all our balloon obsessions and how Thanksgiving is the culmination of our balloon love:

Gift giving: Graduation, valentines day, having a baby, on and on we could list all the times we've given or received balloons with clever pictures and sayings on them.

Sick in the hospital: I never understood this one....but people in hospital beds get a lot of "get well balloons."

Hot air balloon rides: Who doesn't want to ride in a balloon! Fun!

Parties: When did you go to a party where there weren't any balloons???

Meteorology/medical equipment/military: It's true! Balloons are practical too!

Michael Faraday invented the balloon in 1824. He should get an honorary Nobel Peace Prize!

I love water balloon fights and the creepy clowns who twist balloons into animals! And don't forget the "balloon boy scandal!"

Enjoy the parade and Happy Thanksgiving everyone!

Monday, November 21, 2011

Advice for the Supreme Court Justices-American Style

Well we are finally getting to the end point....that place where Columbus thought he'd sail his boat right over the edge of the world! That's right...the supreme court will decide if Obamacare is constitutional. If it is ok for the government to force us to buy health insurance. We should be worried. Because if they all say yay....America is gone. Gone because we will have to rewrite our constitution. Gone because we will then be forced to buy all kinds of stuff we don't want. I don't want to pay to have a lawyer retained on my behalf!

What you say??

Well it's only a matter of time before the government says its your right to have a lawyer! Not just a public defender! Oh no...because the free health care clinics weren't good enough, so I'm sure the public defenders won't be good enough either. So get ready to pay a yearly retainer for a lawyer. Oh that's right! Probably around $10,000 a year I'd guess! Because, for some reason, the legal system has no regulation and lawyers are allowed to charge outrageous amounts of money for their bad advice! $500 to $700 or more dollars an hour! Ummm....reality check....no one is worth that! Oh...and how about we apply those health care privacy rules to the courts? Have you ever been to court?  You can hear everyone's business all up and down the hallways! How come we can't do that with healthcare information? Why is it ok for a lawyer to shout out that his client got an STD from that home-wrecker defendant! But not ok for a doctor to tell the partner they should go get tested??? Why isn't the legal system regulated like the healthcare system?  A surgeon may be worth $500 an hour....but certainly those two-bit greedy injury lawyers are not worth $500 an hour!

It's all so dumb. I have a bad attitude when I think about the fat cat government taking over half my money to do dumb things with it.  If the supreme court says the government can make us pay for healthcare....then they should make the government regulate lawyers too. It's only fair. It's the law world's turn to take the heat. Focus judges! Focus!

Friday, November 4, 2011

Things Judge Judy Might Say to Kim Kardashian

I love Judge Judy. She is the queen of reality tv! So all you Kardashian fans out there...Kimmy's life is not real! Judge Judy IS real! I was sitting around wondering what Judge Judy might say to Kim Kardashian regarding all the hub-bub surrounding her 72 day marriage. Here are some classic Judge Judy Quotes that I know she would be saying to Kimmy in court!

KimK: I'm here in court today to end my 72 day marriage. I realized I got caught up in the wedding planning and I did marry for love, I can't believe I would have to defend this.
Judge Judy: Is the word stupid written across my forehead?
KimK: Well I don't think I should have to give the wedding gifts back because I'm going to make a generous donation to a charity.
Judge Judy: This is not Let's Make a Deal, and I'm not Monty Hall!
KimK: My mom went on tv and said she doesn't like Indian givers and I shouldn't give the ring back either.
Judge Judy: And you ought to be ashamed of yourself!
KimK: Well it was intuition, I realized it wasn't going to work, there's no right or wrong, just intuition.
Judge Judy: Don't spit on my cupcake and tell me it's frosting.
KimK: I've never missed a day of work, but I'm too distraught now, I need time for me.
Judge Judy: Never combine business with pleasure; that's not good business. Got what I mean?
KimK: I am embarrassed by all this.  So can I keep all the money and gifts?
Judge Judy: What school of double-talk did you go to? You're an idiot! If it doesn't make sense, it's not true! You're lying, I can tell because the hairs on the back of my neck are standing up! Byrd, please escort Miss K out of my courtroom, I've had enough and I'm sure the audience has had enough too!

To all you young ladies out there, don't be like KimK, she is no role model!

Judge Judy is the woman to be like. Smart, well-educated, sassy, truthful, moral, ethical, and a good citizen!

It May Be Social Phobia

Question:  I am a 25 years old and I am belong from a village. I am recently completed my bcs(Hon's) and now search a job. I have a problem that I cant share with my family relatives and fellows
even my uncle is a doctor and I am not discussed it with him I don't know why?
now come to my problem yesterday I giving interview for a job I got very depressed and my body start vibration due to  pressure I forgot everything.  This is not now this situation is from the sixth standard of my school.  Even in university life I can't present anything in the front of my class and don't ask any question from my teacher during class because of this situation that I wrote above. and one thing other I am living in a hostel, today when I went to take my breakfast from canteen on my turn another guy come and take my breakfast I told him that its mine he give me  but I got the same situation. There is nothing wrong but I don't know why this happened with me. I am normal in the front of my very closed friend, family and relatives.
But I can't present anything(answers, opinion etc.) on the front of unknown. Please some suggestion to avoid this situation I shall be very thankful to you.

Dear Abid,
It sounds like you may be suffering from social phobia.   Social phobia is an ongoing irrational fear of situations that may involve people analyzing or judging you, such as at parties and other social events or at school.  People with social phobia become overwhelmingly anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. Sometimes, they worry for days or weeks before an upcoming situation. For some people, the fear may become so severe that it interferes with work, school, and other ordinary activities.  Sometimes anti-anxiety or anti-depressant medications help. But what seems to help most is practice. What I mean by practice is, to look in the mirror before you have an encounter and tell yourself, "I'm in control of my mind and my body, everything will be ok and I will successfully present myself in class(or at a party or wherever you are going) today." Say it and believe it. Look at yourself and say it over and over. The key is not to avoid situations but to make yourself face them over and over.  The other part to practice is with friends and family you feel comfortable with. If it's a speech, practice the speech in front of your family at home. If it's a social situation, practice with the friends you feel most comfortable with in a place where you feel comfortable. You will overcome this and you will be successful! Good Luck.

Wednesday, October 19, 2011

Bail Out My Student Loan!

The Huffington Post has an article full of pictures of college grads holding up signs that indicate their college debt. One was even over $100,000! And, I'm thinking most of those Occupy Wall Street peeps are these same debt-ridden-unemployed-college-grads-working-3-minimum-wage-jobs-and-living-with-their-parents-just-to-pay-their-loans-sad-disillusioned-young-Americans!

Well this looks like an easy fix. It's simple and it goes like this:

Dear Mr. President,

I can not be a productive member of society due to my extensive financial burdens related to my student loans. Since you opened your wallet for the big corporation boys and the blatantly blundering banks, will you please bail me out too? Remember me Mr. President? I'm the little guy down here in the park near Wall Street. I couldn't afford a train ticket to protest at your big white house, so me and my friends came down to this neighborhood on the subway. We should be in front of your house Mr. President, but we just can't afford the trip. So what do you say Mr. President? How about forgiving us our combined $1 trillion student loan debt so we can be free to pursue the same American dream the fat cat CEOs and the corrupt bank lenders have pursued since you saved their ass. Thank you for considering our plight Mr. President. We look forward to your answer.

The Occupy Wall Street Gang

Monday, October 10, 2011

6 Crazy Dreams That Mean You Are Totally Normal

Did you wake up this morning wondering what the heck that crazy dream you had means?? Was it the nachos you ate at midnight or was it that damn tequila worm you swallowed?!?

Well, if it was one of the following kind of dreams....then you are perfectly normal...according to the dream experts anyway (www.dreammoods.com)!

1. Chase dreams. You are out of breath running through the woods being chased by a vampire!Or maybe that creeper from the office is chasing you. Whoever or whatever is chasing you...normal. Chase dreams usually mean you are avoiding an issue or situation. Makes sense right? Try and think about things in your life you are not dealing with. Once you can identify what you are avoiding, and make effort to face it, the chase dreams will stop. And...if you are the one doing the chasing in the dream...you are trying to catch up with others or you may be highly motivated to get something done, you have significant drive and ambition.

2. Test dreams. You fail that 3rd grade math test over and over every night! You wake up thinking you're a dumb ass! Well all it really means is you are experiencing some sort of anxiety. Perhaps you are overly worried about meeting others expectations. Or you feel you're not good enough and you worry about letting other people down. All normal. So try and think about what's going on in your waking life...do you want to make your Mama proud, or show your boss you're worthy of a raise?

3. Falling dreams. Off a cliff or down the stairs...you keep dreaming of falling. Normal! You are probably feeling insecure, overwhelmed and out of control. You feel a sense of failure in your waking life. Or...if you think Freud is a genius...then it means you are contemplating giving in to a sexual urge! Be careful!

4. Flying. Who doesn't want to fly? How cool is a flying dream!? And it means good things too. You are on top of things, you have a sense of power and you are a winner! But...if you feel afraid in the dream while you are flying, then you may be afraid of challenges and success.

5. Naked. You are on the bus all nude! Or walking on a crowded street...naked! All normal. It just means you are feeling vulnerable, or you are hiding something and people can see right through you. Maybe you are trying to be something you are not. I like this interpretation...you are proud and have a sense of unrestricted freedom! You look good in your birthday suit!

6. Teeth. Rotting and falling by the handful out of your mouth! How freaky! But normal. It's all about anxiety and fear of rejection. Some say a lack of power and being worried about your appearance.

Hope this puts your mind at ease. You are not crazy!  Flying naked through the sky while taking a test and then falling through the trees and losing your teeth all the while being chased by a flying monkey make you a completely normal person!

Monday, September 19, 2011

Smarties For Dummies - An Ode to Michele Bachmann

Who doesn't like candy? I like candy! Michele Bachmann probably likes candy don't you think!? Well after she ate some crow for that stupid HPV vaccine comment, I'd like to offer her some of those tasty little smarties candies...cause she needs them!

Smarties For Dummies - An Ode to Michele Bachmann
(Dear Michele, an ode is a lyric poem typically of elaborate or irregular metrical form and expressive of exalted or enthusiastic emotion.)

A little pink candy, so sweet and tart
Like Bachmann's words, a spun mythical fart

A little blue candy, such a pleasing infusion
She declared New Hampshire the birthplace of the Revolution

A smiling religious zealot,
Her husband Marcus claims to cure gays.
He does it in counseling,
And somehow gets paid.

Marcus and Michele
A cute couple for sure!
But a box of rocks for brains,
Smartie candy can't cure.

I so desperately want to vote for a woman for president.  Mostly because I'm a woman whose felt and seen our oppression! But can someone please tell Bachmann and Palin the truth....that they say the stupidest things and that they make the rest of us look bad!

When Bachmann announced her run in Hew Hampshire, she said,  "It's your state that fired the shot that was heard around the world!  You are the state of Lexington and Concord, you started the battle for liberty right here in your backyard." ok....ummm...wrong state! Totally embarrassing right!?

Then she spoke about the HPV vaccine. During a debate she questioned a state's authority to force "innocent little 12-year-old girls" to have a "government injection" that was "potentially dangerous."
The following day, she told NBC's "Today" show the story of a woman from Tampa, Florida, who approached her after the debate and said her daughter became "mentally retarded" after getting the Gardasil vaccine made by Merck.  Michele Bachmann needs to shut up! She has a lot of nerve making these statements! As a health care professional, I am telling you that the HPV vaccine is a good thing! A very good thing!

Bottom line...don't listen to politicians or celebrities when they talk about vaccines and medical or psychiatric advice. Please don't.  And, I'm wondering if all the smart and savvy women out there aren't running for political office because....well probably because they ARE smart and savvy!!

Thursday, August 18, 2011

Out of Control Anxiety

Question: I'm in Denver away from my psychiatrist! Having very bad anxiety my psychiatrist put me on klonopin .05mg 3x daily not working was a crying mess so my psychiatrist told me to go to the emergency room where they gave me thru an i.v twice didn't work then they gave me valium it helped take the edge off but I still feel very manic can't see doctor for one 1/2 weeks what to do demand he see me when i get back home?

 Click on comments to read Laura's advice.

I Like Your Bus Mr. President!

How about that bus the President is riding around in?  He's like a rock star in that stealth-looking-star-wars-meets-the-terminator-omnipotent-bus-of-political-righteousness! His message is to tell us all he will announce some big job creation dream in September.  He could have just sent us a message on twitter for crying out loud!

I'm so confused. He's touring the Midwest to announce that he's going to announce a plan.

"The bus tour, which included the states of Minnesota and Iowa that Obama won in 2008, has had a distinctive campaign appearance though the White House has described the three-day event as a listening tour" -Chicago Tribune.

Even the Chicago Tribune, President Obama's hometown rag, is having trouble explaining what this tour is all about! I think the President is having the stereo-typical-proverbial-mid-life-crisis. Yup...his wife wouldn't let him buy a Harley for his 50th birthday so he had to settle for this bus! And, in order to explain why he's riding around in this rock star bus pretending to be a cool guy...he decided to say he's on a "listening tour." Not very creative and not very convincing!

Do you think he has an xbox on that bus? I wonder what his xbox username is? Or a mini-bar his wife stuffed with carrot sticks and healthy snacks? I think he's on that bus right now dancing in his undies like Tom Cruise in Risky Business. It's ok...tinted windows prevent the public from seeing what's really going on.

Visit Eleventh Hour, LLC for more interesting social commentary and psychiatric advice.

Sunday, August 7, 2011

Do We Care About Rick Perry's College Transcript?

The Huffington Post has a cute article about Rick Perry's bad grades in college!  How totally embarrassing. But you know what...even the last of the class graduates right? Someone has to be valedictorian and someone has to be...well, what's the word for the kid whose grades put him/her last in the class?  I searched and searched and there is no word for the last in the class. I even looked up the antonym for valedictorian and there isn't one!  I did find something on Yahoo answers. It said that other countries call the last in the class a dunce!

Well this dunce theory can apply to many fields other than politics. Let's see...how about the doctor who graduated last in their class? Of course! There are doctors out there taking care of your loved ones who got Cs and Ds in school!  Yikes! Are they competent?

Maybe we should start asking to see every one's transcripts. I got a D in Law in Communication at BU. I had to take the class twice and I got a D both times! I totally sucked at that class! So I did the right thing...I did not pursue a career in Law Of Communication!

In the end do the grades matter? I don't know. What I do know is there are people out there who are great at their careers and there are people out there who suck at their careers. As we say in health care when we come across an incompetent doctor..."Even the last in the class has an MD after their name!"

So we should all frame our college transcripts and hang them next to our diplomas! How cool would that be when you walk into a lawyer or doctor office and there is an official transcript for all to see! I love it!

Let's face it...if you saw a doctor's transcript with As in science and math and Ds in woodworking and cartooning...you'd probably think they are stellar doctors and not very good artists...and that's ok! But if you saw a doctor's transcript and they got a C in Anatomy class...maybe you would leave the office! I know I would!

So where does that leave poor Rick Perry? Do you really need good grades to be a politician?  The Huffington Post has a lovely slide show of all the politicians who cheated on their wives! The slide show was created two years ago and it had 18 male politicians! There are even more now! And how about the class of "scandals?" Take a look at this super long list of political scandals. Well, If you get a D in ethics class, a D in morals and values class, and an A in ego class...then you should definitely go into politics!

Saturday, August 6, 2011

Alcohol Issues In The ER

Every day I see several intoxicated people in the emergency room. Many of them drive themselves to the ER and ask for help. Some come in handcuffed and angry. Some are dropped off by family members who have had enough. Some are on probation or on parole and if they get caught drinking or using drugs, it would be a violation of their probation.

And what do I do with these people? I help them. I protect their privacy. I feed them and house them in the ER. I give them medications. I make sure they are comfortable and cared for. Alcohol withdrawal is life-threatening. It's a medical issue that most times warrants an inpatient admission.

25% of all emergency room admissions, 33% of all suicides, and more than 50% of all homicides and incidents of domestic violence are alcohol-related.  According to the Center for Disease Control in Atlanta, there are 105,000 annual alcohol-related deaths due to drunk drivers and related injuries or diseases.

Somehow I feel that I am contributing to those statistics. You know why? Because I am ethically bound to protect my patients privacy. I can not call probation officers, I can not call the police and report that someone was driving under the influence. Some patients really want help. But some come to hide in the ER because they know we can't rat them out. And your tax dollars pay for us to harbor criminals in the ER.

It's a dirty little secret. I look through the newspapers all the time to see if a person I had in the ER has driven drunk and hurt people, or beat their spouses in a drunken rage.  Am I responsible in some way? 

My hospital legal team would say I'm not. But my heart and soul says maybe I am.

Maybe alcohol should be illegal like other drugs. It's certainly equally as lethal as heroine, cocaine, and meth. And it costs the health care system and the tax payers a great deal.  Not to mention the heart ache, physical suffering, and death that inevitably comes.

 O thou invisible spirit of wine, if thou hast no name to be known by,  let us call thee devil.  William Shakespeare:

Saturday, July 30, 2011

We Should Pick Our Next President From Match.com!

Well the last few years speak for themselves. Our country is getting all out of sorts! It's time to break-up with Obama and pick a new partner!  I sent B.O. a break-up text, it's kind of a lame way to break-up, but I just couldn't take his begging to stay together speech anymore! I just couldn't figure him out...one day he liked me the next day he ignored me! Then he got too pushy...telling me what to eat and what to buy and how to act! Then...the deal-breaker for me...he actually had the nerve to ask me for money! I can't be in a relationship with someone like that! So I broke up with him and I just joined match.com! There are hundreds and hundreds of people we can pick from to be our next president!

Take a guy named "Mike" from North Dakota. He has pictures of himself standing in front of his car, in a business suit, and at the gym in a tank top! He likes dogs, he owns his home, he has a 401K, he has two children that he enjoys spending time with. He likes going to the movies, yoga, and Indian food! He sounds perfect right??? Or maybe "Crystal." She has 5 cats and lives in a condo on the beach! She has pictures of herself on the beach and of herself with all her cats. She drinks green tea and likes to jog at 5am every day! She sounds motivated right?

There are so many qualified people on match.com! We should definitely pick our next president off match.com! And...maybe we should pick our congress peeps off of there too!  Cause you know what...we would NOT have picked Senator Wu if he had a picture of himself in that tiger suit posted on his match.com profile! 

Friday, July 29, 2011

Chronic Pain and Severe Depression

Question: My question is how can I get over this severe depression that goes along with my chronic pain?

Click on comments to read Laura's advice

Wednesday, July 20, 2011

Medications For Insomnia

So you're having trouble sleeping and you went to your psychiatric clinician for help. And somehow you left their office with a prescription for remeron (also called mirtazapine). And you're thinking that this remeron medicine is for insomnia, to help you sleep because that's what the clinician said right!? And why oh why wouldn't you believe what a licensed professional tells you!?

Well guess what...remeron is an antidepressant, not a sleep aide! So if you happen to suffer with insomnia AND you're depressed, remeron may be the right medication for you. But if your only issue is a sleep problem...don't you want a medication that's only job is to put you to sleep!? Of course!

First, some effort needs to be put into developing good sleep habits. Sure all the other psych websites give you long lists and long articles of how to magically turn yourself into sleeping beauty! But here's the low-stress version:

* standardize your wake time
* limit amount of time awake in bed
* limit napping
* remove the clock from your vision
* avoid caffeine after 12noon and avoid alcohol after 6pm
* avoid stressful activities in the evening

Second, find a clinician whose not afraid to give you a thorough evaluation and an appropriate sleep medication if your primary diagnosis turns out to be insomnia. Remember, sometimes a sleep problem is really a symptom of some other medical or psychiatric diagnosis. Make sure you ask exactly what kind of medication you are being prescribed. Too often clinicians are prescribing medications that have a side effect of sedation to treat insomnia. Like the remeron...which is an antidepressant with a side effect of sedation. Trazodone is often prescribed for insomnia but it is an antidepressant with a side effect of sedation.  And seroquel is an antipsychotic but sometimes prescribed for insomnia because its side effect is sedation! Don't expose your body to these medications just for insomnia.

As a Nurse Practitioner, I always ask myself..."Is this a medication I would prescribe for myself for this particular problem?" And guess what! I would NOT prescribe remeron or trazodone or seroquel for my own insomnia! I would prescribe ambien or restoril or lunesta. Take care of yourself. Don't accept second rate service. It's your body! And next time you see your clinician...ask them if the medication they are prescribing for you is something they would prescribe for themselves. http://www.eleventhhourllc.com/online-advice/default.aspx

Saturday, July 16, 2011

Bath Salts May Kill You

My job here is to give you the straight story. All my followers out there know I tell it like it is. And as I go to work in the Emergency Room day after day, I see you guys coming in completely freaked out on bath salts. Some of you come in DOA....that's DEAD ON ARRIVAL in case you didn't know.

You are snorting, smoking, injecting, eating these bath salts and you are getting suicidal, homicidal, psychotic. You are dangerous to yourself and all of us around you. You bite, kick, scream, punch, hit, spit at those of us trying to help you. You end up with five officers on top of you as we tie you to a bed with restraints so we can pump your veins full of medications and fluids in an attempt to save your life. You look near death as you scream about wanting to kill yourself, as you scream about seeing and hearing things that aren't there, as you beg us to help you. And we do help you. But please help too...DON'T USE BATH SALTS!

Some treaters may sit here and try to explain to you what exactly the chemical compounds are in these bath salts and how they affect your brain. How they are a stimulant sort of like meth and cocaine and ecstasy all rolled into one. How if you inject them with a dirty needle, you can also get hepatitis, HIV.   But none of that matters if you're dead....

Thursday, July 7, 2011

Antidepressants, Serotonin, You and Me

Just wait a minute! Don't take that pill just yet! So you were at your primary care clinician's office getting your annual check up and you mention to your practitioner that you've been "out of sorts, kind of depressed, not myself." And before you know it, without further investigating your feelings, your clinician hands you a prescription for paxil or prozac or celexa or lexapro or zoloft or luvox. All these medications are antidepressants and known as SSRIs (Selective Serotonin Reuptake Inhibitors). Sounds fancy right? Sounds like a sure bet for happiness right? Well let's do a little more investigation.

Dr. Axelrod won the Nobel prize in 1970 for his research that led to the development of the SSRIs. The discovery of serotonin was a very cool thing because psychiatry became hopeful that they could now "cure" depression. Psychiatry thought they would be accepted as a legitimate arm of medicine because depression was actually a "medical illness," a "deficiency of serotonin." So quickly, the pharmaceutical companies got to work developing the SSRIs, medications that affect serotonin. The SSRIs simpy put, inhibit the reuptake of serotonin, thus allowing a build up of the serotonin.

Serotonin is in your blood. It works in your central nervous system. Serotonin affects mood, emotion, sleep, and appetite. But guess what...90% of your serotonin supply is in your digestive tract and in your blood platelets!  So when we look at the side effects of the SSRIs, we can understand it.

The side effects from too much serotonin include insomnia, rash, muscle pain, bleeding, sweating, anxiety, and GI distress like nausea, diarrhea, vomiting, upset stomach. Well these make sense now that we know that serotonin works in the belly and works in the brain on mood, emotion, sleep, and appetite! In other words...too much serotonin can make you sweat, can make you anxious, can make you bleed, can make you have diarrhea, nausea, vomiting. And...the most annoying side effect...decreased sexual interest, desire, and performance.

There's a cool study that found migraine patients have a higher sex drive. Hmmm...you say?? Yup, it's true! People who suffer from migraines have low levels of serotonin. And people with low levels of serotonin have normal or higher than normal sex drives. So if you increase your levels of serotonin with an SSRI, you will decrease your sex drive!  I bet your primary care clinician didn't explain that to you!

Well all the hype about serotonin seems to only be good news for some of the people some of the time. Some people don't need more serotonin and some people can't tolerate having increased serotonin.  

So what should you do if you feel depressed? Should you try an SSRI? Well you should definitely try meeting with a psychiatric nurse practitioner. Because there just isn't a magic happy pill out there. And what may work for one person, may not work for another. Do you think low levels of serotonin cause depression or does depression cause low levels of serotonin?  I sure don't know! But what I do know, is that when I meet with a client, together, we take the time and seriously examine all aspects of your health, your activities of daily living...what makes you tick.  Sometimes the SSRIs work and sometimes they don't. Well how is that possible? If all those science and doctor dudes said serotonin is the thing that makes people depressed...why doesn't it work all the time for all the depressed people? Because maybe you have a dopamine issue. Or maybe you have a specific life event that's caused you emotional difficulties. Or maybe you have a norepinephrine issue. So maybe depression isn't just a serotonin problem.

Dr. Axelrod gave us a good start.  But I think each person is unique and has very specific reasons and chemistry's and histories... that together, may cause mood disorders. So be good to yourself, don't just take that prescription from your primary care clinician, ask for a referral to a psychiatric nurse practitioner and explore what's really going on in your mind and body.

Monday, July 4, 2011

Why isn't the Adderall working?

Question: My doctor has recently decided that his initial diagnosis of schizophrenia was incorrect. He has decided that I actually have ADHD and has put me back on medication I had been taking previously, Adderall IR.

The problem is that I'm not feeling the effects of the medication. I was on the Risperdal Consta injection for a little over a year, and it's been seven weeks since my last shot, which is the time required for elimination. However, I still feel nothing; I don't notice a difference when I take the Adderall.

I used to feel focused and calm when I took Adderall, but now... nothing. Is this a side effect of the Risperdal? When will the Risperdal stop having an influence on my body? My doctor said it would go away after eight weeks, but it hasn't. I don't understand. Thank you so much.

Click on comments to read Laura's advice.

Saturday, June 25, 2011

Psychiatric Medications - Do You Really Need Them?

So you want a medication for your mood? You think a pill will make everything better right? Of course we think that...that's what the ads on TV tell us! As a psychiatric nurse practitioner, people come see me for prescriptions. People request pills for all kinds of things like poor sleep, mood swings, depression, racing thoughts, and to focus better.  But sometimes you don't need a pill...actually, most of the time you don't need a pill! Shocking right?  Five psychiatric medications made Forbes top 20 best-selling medications list. Three of those five are antipsychotics!

 Let's take a look at this chart, NIMH (National Institute of Mental Health) shows us the percent of Americans with mental illness.  It helps put things into perspective related to having 5 psychiatric medications on Forbes list of best-selling medications....in other words, I think people who don't necessarily need those medications are being prescribed those medications.
Courtesy of NIMH
Lots of people have difficulty with symptoms that seem to be part of a mental illness. And doctors are right there, ready to give you a prescription for your symptom. But what if your symptom was the result of a vitamin deficiency? What if your depression is the direct result of the loss of your spouse? What if your anxiety is the direct result of an overactive thyroid? Has your doctor ever said, "Gee, I'm sorry you lost your home and you have to care for your kids in a shelter, here's a prescription for zoloft, it will help with your mood."

But maybe all you really needed was help finding resources for homeless families, or a blood test for a B12 deficiency instead of a pill. Or maybe it's something that will take a while to figure out. Doctors don't have the kind of time needed to figure out what's causing your symptom. It's easier for them to give you a pill for the symptom! Really...it's an awful way to treat people. And we all deserve better care.

Some research has shown that antidepressants are no more effective than a placebo. Because maybe all you really need is therapy and learning some new coping skills.  As a prescriber of psychiatric medications for 11 years, I know who needs a medication and who needs to learn good sleep hygiene habits!

And all the psychiatric medications have some significant side effects. Forbes top medication list has those 3 antipsychotics in there! Do you really think you need an antipsychotic?? According to Prescriber's Letter, more money is spent on antipsychotics than any other class of psychiatric medications. There are more than 10 antipsychotics I can pick from to prescribe for you. When we decide to add on an antipsychotic, it should be done with extreme care and a thorough history.  There's cardiac issues, weight and metabolic issues, sedation issues and extrapyramidal issues, not to mention all the drug-drug interactions and cost.

So consider all the options and all the risks before you accept that prescription from your doctor. And, give a Nurse Practitioner a try! We are trained in a holistic manner. We look at the whole you. You deserve a complete work up for what ails you. You deserve a full explanation of each medication considered for you and you deserve to hear possible alternatives.  Please don't settle for a pill.

Thursday, May 26, 2011

My Spouse is Suicidal

Question: My husband recently relapsed after 9 years of sobriety. He is currently in a rehabilitation center. He has opened up to me and the staff of incestual sexual abuse as a child from ages 4-10. He says he has been wanting to commit suicide for years, he is very depressed and rarely happy. He will be released soon and I am very concerned about what I can do to support him. I found a detailed description of how and where he was going to commit suicide. What do I do?

Please click on comments to read Laura's advice.

Monday, May 2, 2011

Fool-Proof Method To "Erase" Our Trillion Dollar Debt

So Obama tried to bully the S&P and get them to keep America's credit rating at AAA. The bestest, highest, credit rating a country can have. And the Prime Minister of Greece was crying about being held hostage by the credit rating peeps.  Here's a direct copy from a Huffington Post article. George Papandreou, in a written statement posted on a government website early Friday said the agencies, instead of elected governments, "are seeking to shape our destiny and determine the future of our children." 

Boo-Hoo you big babies! Is this for real? How many of us peons have been bullied by the big three credit bureaus...Equifax 1-800-685-1111, TransUnion 1-800-916-8800, Experian 1-888-397-3742. These three devils hold us hostage on a daily basis, forcing us to accept ridiculously high interest rates and wrapping us in red tape, oppressing us with debt-to-income ratio bullshit!  If we have to kiss the devil's ass...then so do the countries!! Who do these leaders think they are? They should be held accountable to their budgets and spending patterns the same way we are.

Maybe Obama should file bankruptcy for America like all the regular people out there!  Yeah, he can borrow this American rationale...it's a winner for so many! Just go before some judge and say you have a "real bad sex addiction" diagnosed by a certified psychiatrist, and, due to the nature of your "illness," you have racked up 5 trillion in credit card debt in online porn memberships! Oh it works every time! China will feel so sorry for us! They will be "embarrassed" for us! So embarrassed that they will forgive all our debt just to sweep the "scandal" under the proverbial rug.

It will work...it always does...

Saturday, April 16, 2011

A Place To Share Our Stuff


Every day women fight for equality and recognition. It is often a silent battle that we don't even know we are engaged in. And every day women realize they have a voice...they have something to say that will most definitely help their fellow female warriors. But where can we share our stuff?  Well I know... The Jane Project!

The Jane Project is a blog about "being and living as a female in this modern world." The Jane Project is a "safe place to speak out about our own truths through art, letter, stories, and pictures." 

I encourage all my readers...men and women...to check out The Jane Project blog. It is insightful, wonderful, and celebrates all of our unique experiences and perspectives. So check it out!

Monday, March 28, 2011

Donald Trump Just "Birthed" a Blunder!

I like Donald Trump. He's a super-smart business mogul! But lets face it, the dude's got some serious brass balls in his pockets to go down the road of Obama birth certificate shenanigans!  What is he thinking? He goes on The View and talks smack about Obama being born "elsewhere."  He gets interviewed for the papers and actually states that he does not believe anyone in Hawaii who says they remember Obama's birth!

Why is he doing this? Now I'm the first one in line to sign the impeachment papers and rescind the Nobel Peace Prize...but this "birther" thing has got to stop! The Donald actually sounds like a lunatic. He's all paranoid...thinking there's a conspiracy surrounding where Obama was born. Is Fox News paying him to do this???

If someone out there in blog land can please post some comments about their theories as to why Trump is losing his mind, I'd appreciate it!

Here are some important facts to assist you with your analysis:
1. The Donald wants to run for the presidency.
2. He has the celebrity edge going for him.
3. Celebrities are all non-tax-paying-crime-committing-never-going-to-jail-my-lawyer-will-get-me-out-of-it-liberals.
4. Donald is a stand-up-fiscal-conservative-married-a-few-times-womanizing-republican.
5. He's rich.
6. His hair is....odd.

I can't wait to hear your theories!

Thursday, March 24, 2011

Did Charlie Sheen Help Bill Zedler Write That God-Awful Creationist Bill?

So Bill Zedler is some kind of politician in Texas. He's in the news because he wrote House Bill 2454 that prohibits "discrimination by public institutions of higher education against faculty members and students based on their conduct of research relating to intelligent design." What...? Are you scratching your noggin wondering what the heck is going on in Texas?

What, they aren't worried about the border anymore? No more troubles with unemployment? No more budget woes? Everything is going so well in Texas, Billy-boy had so much time on his hands, that he wrote this bill about....ummm...about...well if I had to guess...it's about the missing link?  Something about man was an ape or maybe God made man or maybe God made an ape that turned into a man? And, which ever one you believe, no one can bad-mouth you in the state of Texas? Yeah! That's what his bill is about right?

I'm figuring Charlie Sheen helped him write it. I think they sat down together and drank some tiger blood and started howling at the moon or growling or maybe ran naked through the wilderness and said to each other, "We are man, we know stuff about the world, let's write a law about stuff!"

Cause there is no other explanation for the crazy-talk going on in that bill!

First, I'm pretty sure it's kind-of sort-of illegal because it's really about religion and hocus-pocus-poof-the-world-was-created-in-six-days-by-intelligent design-which-is-really-creationism-disguised-as-science-so-it-can-be-taught-in-schools-mumbo-jumbo-fake-you-out-drink-the-kool-aide-kind-of-rhetoric!

Second, what kind of "research" is he talking about related to "intelligent design"...a bible study class?

Third, how dumb does he think Texans and Americans are? Intelligent design is creationism...duh.

Fourth,  what was Charlie Sheen thinking!? Charlie just might have ruined his reputation by hanging out with Bill Zedler!

Saturday, March 12, 2011

Screw All This Budget Crap...Let's Talk About Clarence Thomas!

Come on...enough already...budget smudget! How boring to hear all the bickering over money! Money is why marriages break up, money is why friendships are ruined, money is why there is crime!

So let's change the subject! How about the weird mutism of Clarence Thomas! What's up with the no talking thing? I'd like to try that at my job. How long can I get away with it before I was either fired or forced into therapy?!? But if you are a supreme justice, you are like a Demigod!  He sure wasn't mute when he was talking to Anita Hill about pubic hairs....remember that!?!

Clarence, when questioned about his missing vocal cords, said something about surgeons not talking when they take gallbladders out because they already know how to do it. Umm...Clarence....I've got news for you, there are often complications and anomalies, and surgeons do indeed discuss the case and how to proceed during pretty much every surgery! 

And even crazier...his politically weird wife can't seem to shut her own pie hole. She recently asked Anita Hill to apologize to her husband! I threw up a little in my mouth when I heard that one! Virginia Thomas makes boatloads of money doing some kind of super-conservative nonsense and hubby Clarence somehow forgot to note her $600,000+ salary on his disclosure papers for court!

Maybe he's not mute...maybe he's just plain dumb. How do you not know your wife makes gobs of money? He purposefully left it off his disclosure. That's just unethical and wrong. Why isn't he in trouble with his boss for that?  How about the word impeach? Do you think he understands what that means?

Sunday, February 20, 2011

Union Smackdown!

The American motto "Greed is Good" is finally catching up with the unions. For decades we have kowtowed to the unions excessive demands and finally we are fighting back! We should all be mad...mad at how the unions played a HUGE role in the demise of America. That's right, the unions will now take their place in the history books as a key player in bankrupting each and every state that kissed those corrupt union booties!

Ok, quick little history lesson: unions were once good. It's true, The Boston Tea Party, unions improving worker's conditions, gaining legal protection for us peons from our exploiting employers, instituting industrial safety, regulating child labor. All good stuff! And we thank you! But somewhere along the good deeds route, the unions came upon a fork in the road and chose the greedy path of corruption.

And so here we are. Thank you Governor Scott Walker of Wisconsin for saying we ain't gonna take it anymore! He is awaiting the passage of a bill that eliminates public employees collective bargaining rights. Yea Scott!

The unions are victims of their own success. Union-made products have become so expensive we all started buying foreign-made stuff. Union leaders kept demanding more and more with their irrational pensions, unsustainable health care benefits, and their outrageous wages...that we are now in major debt and buying Chinese cars!

The unions corrupt power must be dissolved! There are millions of people ready to take over their jobs! People who would be so happy to have a job! People who would be proud of the work they do no matter what it is! You all know what I'm saying here...we have all worked with union members who are so entitled they sit around and don't do their jobs! I'll say it...many, many union workers have taken advantage of their employers and have done a crap ass job but are allowed to keep their jobs because of the union! Disgusting!!

Union members who partake in that bullshit...you know who you are...and now you are outed!! You should be ashamed.

Standing ovation for Governor Scott Walker!

Saturday, February 12, 2011

Common Sense List: What NOT To Buy Your Girl For V Day

Monday is Valentine's Day. The pressure to come up with an original-thoughtful-caring-gift-of-love gets more complicated every year! So stressful! Who can compete!?! Not to mention when a man is "blinded by love," his common sense blows out the window! So here is a friendly reminder of the top 3 things NOT to buy your girl for Vday!

1. A Teddy Bear: Just don't do it! That damn bear company sells bears in all kinds of outfits. Tutus, lingerie, combat gear, panties, mailman outfits, aprons, pjs, hats, leather, stilettos! And ladies, when you get the bear, please don't keep it on your bed! Creepy! Gentlemen, we don't want a stuffed animal wearing clothes, ok?

2. Pajamas:  No, no no. They keep advertising those pjs with the feet and the hoodie and the tag line is something about "just like the ones she had when she was little." Creepy again! If I want footie-hoodie pjs, I'll buy them myself and only wear them when I'm completely alone. I'm pretty sure Brad Pitt is NOT buying Angelina Jolie footie-hoodie pjs!

3. Vacuum cleaners/pots/pans/dusters/cooking ware: TThis category speaks for itself. Ladies, if you get anything in this category, please break up with your man. Seriously...it's a deal breaker.

Good Luck Guys!

Don't overdo the benadryl

Question: They gave my mother benadryl in the hospital to calm her down but she got wild! She is 84 and the doctor said benadryl helps calm people down when they are nervous. So what happened? Is she allergic to it?

Click on comments to read Laura's advice.

Saturday, February 5, 2011

American Nut Job

A short story that may be partially true, or all true, or not true at all...you decide.

Some people swore that the house was haunted. I heard voices; that’s for sure, but I never saw anything. As a matter of fact there was nothing out of the ordinary in my Grandma’s house except for the voices. And when I hear the banshee, it reminds me of the smell of blood-stained leather... a sort of tangy raw stench.

Soon I'll be surrounded by the scent again. Wrists and ankles encased, pants lowered to expose a small square of skin just wide enough to accept a 2 inch needle. It will happen the same as always, a behavioral mystery I find half controls me. Only half I say because if I really think about it I control at least half... maybe all... of my pseudo-scheduled visit to the psychiatric ER.

You see, I'm an official American nut job. That's what they call me behind the sound-proof glass where the nurses eat drink and be merry.  My grand entrance is anticipated as it is about 6 to10 days after the first of the month that my social security disability check is used up. Not for rent, food, clothes...but for an 8 ball, a bundle, a pint, a quart, a carton. 

I hope they don't put me in a room with a demented grandpa again. Now those are the real crazy people. You can't really blame them when they go commando and start choking you. If anyone ever tells me I've got that Alzheimer’s, I'm doing like that lady in the paper did.

She was only 65. I say only because these days women live till like 85 or something. So she finds out from some bone-headed Indian doctor that she's got the dementia. Well things are pretty much over at that point. It starts with losing your car keys and ends with you shitting yourself and screaming racial slurs at the nurse.

So I liked this lady's idea. She hears the news from the doctor...it’s confirmed, she’s got the Alzheimer’s. So she waits till dark, puts on her nightgown, brushes her teeth, says goodnight, and walks to the highway. She waits...then with all the courage and bravery of a marine she runs.  Her bare feet defiant to the rocks and litter on the side of the road. Her nightgown billowing like the American flag proudly moving in the wind.  She faces the oncoming traffic like superman and steps in front of a truck that cannot break in time.

Old people have guts. "Pass me that pipe," my buddy says. He yells it again and I forgot about the old lady for a minute. "Oh yeah dude, here you go." This month our motel room is on the top floor. That's not good. People below us complain about the noise. I might be heading to the ER tonight if we get kicked out.

I like the ambulance ride. I tell the same story every ride. You know, the story about the haunted house. How ever since I was in that haunted house I’ve been hearing voices...ghost voices I’m sure. But the doctor’s say its “auditory hallucinations.” And they keep giving me a shot of some kind of medicine to “make the voices go away.” And the voices do go away, so I don’t know if there were ghosts or not now. And I don’t know what’s real or not now.

That medicine...that stinging, stabbing, shot did something to me. It changed me. Nothing was ever the same again after that.

Sunday, January 23, 2011

Food, Fatness, and Conjecture

Food containers are getting smaller and smaller and the prices aren't changing! It's been on a few news shows. There are several theories as to why this is happening...

1. Michelle Obama: Oh yes! She is obsessed with our weight! She makes me want to eat even more just for spite! Why does she continue to tell us what to do? I bet she gathered all the foodie CEOs and said, "Look here, let's shrink the packaging, give fatties less food for the dollar, and we have a win-win situation!" People will lose weight like Mrs. Obama wants, businesses will make money off us as we get less product for our money, and the health insurance companies will have a 350% profit year instead of a 250% profit year because we will be so healthy we won't need any urgent health care related to fatness!

2. The metric system has finally confused Americans to the point of total stupidity: Maybe it's all an illusion? That damn metric system we learned in third grade continues to haunt us!  Is that ice cream sundae 1 pound of all-American goodness or 0.45 kilograms of an unsatisfying mini taste? Oh weight...1 pound IS 0.45 kilograms! Hmmm....which sounds like more?? How much can I eat?? How much should I eat?? Damn metric system!

3. Einstein's theory of relativity: So this super-genius brainiac said something about size and volume being relative. Something only appears larger or smaller from our relative point of view. Yeah! This is how most Americans role! Mind games people....mind games! I'm not fat! I just look fat from that angle you are standing at! Where are those carnival fun mirrors when you need them.

Tuesday, January 11, 2011

I' m A "Ho" And So Are You!

How many times did you do something you did not want to do? Me too...bunches of times! Got coerced by my boss, got coerced by my parents, got coerced by my teachers and on and on. Let's start with the definition of coercion.

Coercion is forcing another party to behave in an involuntary manner.

I hate it when I'm coerced! At work, the union tried to get me to join, Yup, they talked a fancy-flowery-let's-hold-hands-and-be-as-one with a power point presentation. I think unions would waterboard  people if they could....to get them to join that is. 

James Garfield said a law is not a law without coercion behind it. There are all kinds of weird laws that coerce us.     

"Every government is a parliament of whores. The trouble is, in a democracy, the whores are us."  PJ O'Rourke said that. It's true. We have been coerced by our "pimp!"  Here are just a few of the mind tricks we turn:

1. We believe NPR, FOX, MSNBC are unbiased.
2. We believe priests, doctors, and scientists unconditionally.
3. We let airport workers touch our junk.
4. We think health care is a constitutional right. 
5. We believed Obama when he said, "We need earmark reform, and when I'm President, I will go line by line to make sure that we are not spending money unwisely."

Yup...we have been coerced into turning mind tricks for the government.  We are "hos."  I'm so ashamed,,,Let's go to rehab. 

Eleventh Hour Moments