October 27, 2008 I just noticed that most of my image links and video embeds were broken. I’ve fixed the video embedding problem… but most of the images are still broken. And I think the only way to get them working again is re-upload them all.
Well guess what? That’s gonna take some time. Haha.
So in the meantime, please pardon the breakage. The words are what’s important anyway, right?
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July 14, 2008 Update (8/4/08): After careful reconsideration, I’ve decided NOT to retire RMA. There’s still a lot I can do here. But you will have to get used to the more sporadic posting schedule….
A lot has changed around here over the past four years. Pages have come and gone… features have been added (and some have been taken away)… and, of course, the theme has changed about 50 trillion times. I’m indecisive at times… sue me.
A quick glance at the archives will show one other thing that’s changed: I hardly ever post here anymore.
At first I thought it was because I was suffering from writer’s block. Then I got busy with other things and just didn’t have time. When I left the hospital I lost a great source of inspiration. But I’ve been back there for almost a year now… and the inspiration hasn’t returned.
And it’s because I’ve changed… and so has my approach to blogging.
I’m just not into writing the big, wordy posts and running my mouth as much as I used to be. When I’ve got something to say I prefer to say it and move on. Short, sweet, and to the point.
But that wouldn’t fit in very well with what’s been going on here at RMA for the past four years. I feel confined here. And I feel like a massive change in both topic, style, and format would be awkward… and it would impact the content that’s already here in ways I wouldn’t like.
Luckily I found the answer to my blogging dilemma in Tumblr.
Tumblr is short, sweet, and to the point – just like my new blogging style. Oh sure… you could write and ramble on for hours using Tumblr. But I’m not sure that would work very well with the format. If you’ve ever looked at the back-end of WordPress (which powers RMA) you’ll understand what I mean when I say “complicated”. Options… settings… boxes… buttons… tabs… EVERYWHERE.
Tumblr is the epitome of simple. You can customize it and change some settings here and there. But it is simple enough to use that I honestly think my parents could use it without me having to show them a thing. And not only is it simple – it’s portable as hell. I can post from anywhere and from any device: my computer… my iPod Touch… my cell phone… anywhere.
If I take a picture of something funny or strange with my phone… I can just shoot it over to Tumblr with a caption and call it done. No more emailing it to myself, setting time aside later to format it and write some big wordy post around it.
It fits my lifestyle and my personality perfectly. Unfortunately, WordPress does not any longer.
So it is with both sadness and joy that I make two announcements:
So there you have it – the good news and the bad.
Reader Meet Author is going into retirement. It’s been an awesome ride over the past four years (and several blog-related breakdowns). Thanks for coming along.
Luckily it’s not over, yet. Hopefully I’ll see you around Derick Phillips dot Com.
Posted in Blog Related, Personal No Comments »
May 26, 2008 
I’ve often thought I had an addictive personality. And it would appear that that quality extends even to video games. Until about three weeks ago, I spent almost every free minute I had playing that game. I know… it’s almost sickening to admit.
Combined with the movies flooding in from Netflix (there’s a shipping center here in town so turn around is quick) and the stuff on my Tivo… I’ve been a media whore as of late.
I upgraded RMA to the newest version of WordPress yesterday and that’s when I realized I hadn’t written anything since April. *Sigh* So sad… I know. In response to me telling her that I’d upgraded RMA, my sister said “now if only you could find time to write on it”.
I got the message.
Someone come over and take my copy of Call of Duty 4… and my Tivo… and my Netflix account. I may need an intervention.
Posted in Blog Related, Personal 3 Comments »
March 31, 2008 Last night was cool and rainy… so it seemed like the perfect night to open the windows and let in some fresh air. The problem is, as I’ve pointed out numerous times, I live across the street from a bar. And Saturday nights are karaoke night. Normally I find the sounds coming from the bar mildly entertaining. There was a smashing rendition of a Creed song last night that particularly made me laugh.
But at around 1 am, as the bar was beginning to wind down and get ready to close, another sound began to flood through my open windows: an obviously-drunk, shrill-voiced, ranting woman screaming the word “NOW!” over and over again.
Think nails on a chalkboard meets Fran Drescher doing her impersonation of a cat being skinned.
And she just kept going… over and over and over again for what seemed like ten minutes. “NOW! NOW! NOW! Come here NOW! NOW! NOW! NOW!.” If I’d been at Wal-Mart I’d have imagined she was talking to a disobedient child. If I’d been at the park I’d guess she was talking to a dog that wasn’t quite ready to stop rolling in the poop.
But no… she was at a bar filled with what I can only assume were adults over the age of 21. And apparently one of them wasn’t moving fast enough for her. I can’t really blame the person she was screaming at for not listening. I wouldn’t want to get close to a sound like that. You know how looking at the sun will eventually burn your eyes out? I’m willing to bet listening to that “NOW” in close proximity would cause the blood to spring forth from the ear canal.
And I was hearing it from across the street. I can’t imagine what it’d be like if I was right there.
So my question is: how did this woman not know that what she was doing was not only violating city disturbance ordinances, but also just annoying as hell and probably counterproductive to her cause? Seriously. You can’t tell me that her screeching NOWs usually work. I find it hard to believe that being obnoxious and loud and annoying actually helps a person get by in the world.
If so, I’ve been going about things all wrong.
Do people like this not know that they make the rest of us want to apply pressure to their jugulars with our bare hands? Do they not know that annoying does not equal a good way to deal with people? And it’s not just Ms. Drescher-skinning-a-cat from last night. It’s all of the people who go through life being loud, obnoxious, rude, and otherwise oblivious to the rest of the world.
I really wish I had a way to record the sound I heard. You wouldn’t believe it. Whatever you’re imagining in your head, multiply it by an annoying factor of ten. Part of me says that it wasn’t really as bad as I thought it was. Part of me says I was just being overly sensitive because I was in bed trying to sleep (which is probably true). But the rest of me says that this was by far the most annoying sound I’d ever heard in my entire life.
It was the first time in my life that I’d wished I owned a weapon capable of distance attacks.
Just a pellet gun. Something to get the message across without actually hurting anyone. A nice, fast pellet to the ass would have made me feel much better. Or perhaps one of those nets that you can fire from a gun. Ya know… like a projectile spider web. Fired directly at the offending mouth.
I guess it’s a good thing I’ve got a violent video game to take my frustrations out on. Now then… where’d I put that sniper rifle…
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March 30, 2008 When I originally went to work at the psych hospital, I spent most of my time right out on the front lines of direct patient care. I spent more time with our patients than the nurses, doctors, therapists, or just about anyone else (save for the other technicians, of course). We did groups with them all day long, took their vital signs, did “checks” every 15 minutes, and manned the desk of the nurse’s station that the patients have direct access to.
One of the most common reasons a patient would approach the nurse’s station was to ask for medication. Most of their medications are scheduled for certain times of the day… and they don’t have to ask for those. The med nurse delivers all scheduled medications when they’re due. But every patient also has access to PRN or “as needed” medications. We admit all patients with a standard list of these PRNs: Tylenol, Mylanta, Milk of Mag, Carmex, and eye drops. In addition, they almost always come with a few PRN medications specific to their situation.
In my front lines position, I never really knew what medications a patient was on. It wasn’t my job to know and I basically acted like a relay between the patient and the nurse: “Such-and-such is asking for something for a headache” or “So-and-so is getting agitated and might need a PRN”. Now, however, I see every single medication that every one of our patients is on, be they scheduled or PRN.
And let me tell you: the number of medications some of these people are on would floor you.
When new patients come in, they’re generally already on some meds. Their outside psychiatrist, family doctor, specialist, etc has already created a medication regiment for them. Generally speaking, we don’t mess with those regiments unless it’s believed that some medication they’re either on or supposed to be on (and not taking) is the reason they’re in psychiatric crisis in the first place. I guess it’s a generally accepted faux pas for one doctor to mess with the treatment of another one. Who knows. But 9 times out of 10, the only changes made to an existing medication regiment are substitutions for things we don’t carry.
Let’s do a check here real quick. So far we have medications patients are on before they come into the hospital (for anything from allergies, to medical conditions, to psych drugs). We add on a list of PRN medications and anything we’ve had to substitute. That’s not too bad I suppose.
But it gets worse… just wait.
Within 24 hours of being admitted, all patients are required to be seen by a family practice doctor in addition to their psychiatrist. So the psychiatrist adds psych meds – sometimes multiple psych meds – to both the list of the scheduled medications the patient gets and their list of available PRN medications. Then, the family practice doctor comes in and usually adds a med or two here for some non-psych medical condition or out of whack lab result.
So now we’ve got the meds the patient comes in on, our standard PRNs, the psychiatrist’s scheduled meds, the psychiatrist’s PRN meds, the family practice doctor’s scheduled meds, and the family practice doctor’s PRN meds. Keep in mind, of course, most patients have multiple changes and adjustments made to our part of the medication regiment while they’re in the hospital. So the list can continue to change for as long as we admit the patient.
Exactly how many medications are we talking here?
It’s not uncommon for most people to have some medication that they take on a daily basis. Allergies… blood pressure… depression… cholesterol… almost all of us are on medication for something. And we take these meds, what… once… maybe twice a day? That’s not bad at all. Easy to remember… and generally easy on the body. A little foreign chemical here and there doesn’t normally do too many terrible things to our insides.
So how many medications would someone have to be taking to be considered over-medicated? Three? Five? Ten? Twenty? How about forty? Would forty medications be too many?
Well guess what, folks? I’ve seen patients in our hospital pushing that many available medications. Now maybe they only have 15 or so scheduled with an additional 15 – 20 PRNs available. But still… 15 medications to take every single day at various intervals throughout the day?
Some have two or three meds for depression or mood stabilization… a couple of anti-psychotics… an inhaler for respiratory problems… pain medications… allergy meds… anticoagulants… blood pressure meds… diabetic meds or insulin… ointments/creams… and any number of other pills to for a wide variety of health issues. On top of that, they may have additional PRNs for pain, agitation, psychosis, anxiety, constipation, migraines, etc.
Don’t tell me that all of these medications aren’t interacting and possibly making things worse.
I just don’t believe it. You can’t put that many foreign chemicals in the body and not have some sort of adverse reaction. The problem is, we normally just treat those adverse reactions with – you guessed it – another medication. Case in point, it’s not uncommon for our patients to have scheduled, PRN, or both scheduled and PRN doses of Cogentin… a drug used to treat reactions from other medications. Now what does that tell you?
Part of the problem lies with the doctors. And some doctors are worse about piling on the pills than others. Between not messing with other doctor’s orders and approaching every situation from a ‘what pill can I use to fix this’ mentality, it’s no wonder some of these folks are on a dozen medications. Is it just our hospital or just psychiatric hospitals that this pertains to? Of course not. I see it everyday with non-psych issues and within my own family. My parents are probably on ten different medications between the two of them and not one of them is psych-related.
Part of the problem lies with the patients themselves. As unfortunate as it may be, a lot of our patients want as many drugs for as many things as possible. They either enjoy the feeling of being doped up to the point of near unconsciousness or they don’t want to try to actually deal with their problems. They go to as many doctors and as many hospitals as they can complaining of the same issues over and over again so that they can get as many prescriptions as possible. I don’t know how many times I’ve talked to pharmacies calling
because a patient we’ve discharged has come in with prescriptions from our doctors for the exact same medications another doctor is already prescribing. And the patient just “forgot” to mention that to us… of course.
But society as a whole is also part of the problem. We’re so quick to look for a pill to fix all of our problems. We want the quickest, easiest, least painful way to deal with anything life throws our way. Why work through an issue if we can just medicate depression away? Why change diets and eating habits if we can just medicate our cholesterol down? Why waste the time learning coping skills when there are pills out there that can make your anxiety disappear just like that?
If science can discover a way to alter our biology to compensate for an unhealthy lifestyle or a maladaptive way of living, you can bet your bottom dollar people will line up to get that chemical fix. For some medical conditions, a pill is the best option. Some people would die if it wasn’t for their medications.
But come on. When does it become too much? If it takes three medications to ease your depression, don’t you think there’s a bigger issue? If you have to take two different pills three times a day to keep your anxiety in check, isn’t there a message from your brain being missed? And is it possible that you wouldn’t feel so disoriented and drugged all the time if you weren’t taking ten medications a day for things that could be dealt with in a better way? You wouldn’t need that Cogentin to keep the shakes away if you didn’t have all those pills to take!
Where do we draw the line?
Posted in Questions, Rants, Society 5 Comments »
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