Why waste time typing in the shout box when you don't get post credit? Now that we know that Amie logs the shout box anyway, let's make a pseudoshout box here!

In a fury of narcissistic rage, I deem it J.P.'s office. Thanks to whatever minion came up with that idea.

So Ken, this is where to bring it!

300 posts 'til I catch up to Sushi!

Mmmmm, sushi.

I think we should have a standing rule that the first sentence of each post/shout should refer to the the last sentence of the previous shout. That way we can take them all and publish them as a book of poetry.

But would it be a
Real book of poetry with
no haiku chapter?

Yeah, if we want to make this the ultimate thread, it'd also have to have:

... an argument over amp wattage requirements
... definitions of "bright"
... discussion of "break-in time"
... a nasty political and/or religious rage virus
... everything we were doing "last night"

help me out here ...

You forgot cables and tubes.

Yeah, and beer, jokes, wine, grilling, and music/movie reviews.

"who you are have seen in concert lately"

Of course it would not be a proper book
of poetry without haikus therein.
But please do not forget the other great
framework within which you can operate,
for iambic pentameter does make
the written word flow like a lazy brook.

Peter,

You
Need
To
Try
Harder

Show off.

Yawn.

Robb, you need to only press ENTER on special occasions.

Bren R.

Alas, I cannot
argue.

"Seroquel Sue" is our lunch drug rep today. She often brings sandwiches from a cafe, or Chili's fajitas.

She has personal space issues, so our staff calls her "Air Hug Sue" at times.

Being a doctor, there must be some interesting nick names for people at your work, care to share some more?

He's got an African American client with ADD. They call him "The Black ADDer"

ba domp psht

Is this a medical office? Do you take blue cross blue sheild?
anyway
I have a dream where i'm wigwam then a teepee - WigWam - Teepee - WigWam - Teepee -WigWam - Teepee - What do ya think?

I think I no see your wampum yet.

You're two tents.

*groan

Seroquel Sue didn't make it for lunch. She blew a tire on her company car.

Good thing I had some homemade chicken soup in the frig.

Got back to hot tea drinking today after a few days without it, and I'm perking along better.

To be that car...

More precisely, I think she blew a seal.

Nah, it was just ice cream.

and Girardelli brownies.

When the Shout box content has faded from our memories, will we be wondering "WTF?!" at these apparent non sequiturs?

Not with a wonderful resource like this thread.

There are tornado warnings in the Fredericksburg area tonight. May your force field hold out, JP! Hang in there.

Yikes! Stay safe, JP.

I'm safe! There was a big thunder and lightning show, but that was all at Medic8r Manor. The worst of it went through the county to the west (Orange County).

Come to think of it, I suspect rural Orange County, VA is a lot different than that other Orange County.

I'm sure there are least a dozen Orange Counties in the US, I know VA, CA, and NY have them -- and Florida must, as well.

Negative Orange County, on the other hand....

I live in Orang county NY. Also Disney World in Orlando is also Orange County.

Disneyland is in Orange County, CA. It's a conspiracy.

There's 8 Orange Countys in the US. Gotta love wikipedia.

Out of the season finales I've recently watched, I liked the Office the best (no surprise). My Name is Earl and Desperate Housewives were OK.

Uh, everybody here watches Desperate Housewives, am I right, fellas? While wearing their pastel shirts and drinking white zinfandel or Zima?

Only you, Doc. Only you.

I wear Hawaiian shirts!

I confess to having watched it with my wife more than once, but never alone.

I watch it whenever there is not a good sporting event on. I did catch the season finale and found it pretty entertaining. I don't like the show enough to ever watch reruns, though.

Biggest disappoinment was the series finale of Scrubs. For such a great well written series to end so lame it annoyed the crap out of me.
Jake

Yeah, the medieval theme didn't do it for me either. At least it looks like ABC will have a chance to do better when they pick up the show mid-season next year.

My favorite Scrubs moment was when one of the guest star doctors interrupted the opening credits to correct the improperly displayed chest x-ray. The heart goes on the left, dum-dum!

Some sort of box of noodles just walked in.

Well, actually, a drug rep was underneath it. Will go check it out and report back.

Make sure it's not Ken in disguise.

My wife spent many years as a nurse in a clinic. I spent a lot of time in the waiting room, wondering if she would ever get off work to drive home. As part of that, I experienced a lot of drug reps who were also waiting. They are indeed a unique segment of the human race.

Is ABC picking it up? I thought either the actors or the writers did not want to do it anymore. but since that ending was so generic maybe they are moving.

After intense questioning that stopped just short of waterboarding, I can safely say that it was not Ken but, indeed, Steve the friendly Focalin XR rep. Sorry, Steve. If that is your real name.

Ken's probably still recovering from his dinner last night. He'd look like a pregnant noodle, I'd imagine.

And now that I've imagined that, I can't get the image out of my head.

Yeah, sometimes I like to pick battles with them, shoot down their arguments, tell them their drug stinks, try to get them flustered, etc.

Usually I eat their food fast and say thanks, then run back to the office and chat with you guys.

<Homer> mmm, pregnant noodle ... </Homer>

Didn't Pregnant Noodle open for Negative Orange on their last tour?

I'm sure CV has the t-shirts to prove it.

Yeah, the ones with the dragon and the unicorn, you know, from the album cover.

Sean, congratulations in advance on your 3000th post.

My Maxima just passed 75,000 miles, so it's a time of milestones!

Hey, thanks!

Unfortunately my ratio of helpful posts to trivial banter has severely decreased. Or, increased--however you want to look at it.

Whoo hoo, chalk up another post count padder!

I got nothing, other than the fact I'm going back to that restaurant again tonight. Mwah ha ha, fear my noodleness.

I wonder if CV's ears burn every time someone says "Negative Orange"?

Are you sure you didn't just have a vision of the Flying Spaghetti Monster? Did he touch you with his noodley appendage?

(sob) I don't want to talk about it!

Jeez, JP. You were right. This stuff is Gold!

I'm a FSM agnostic. I acknowledge that it is possible for a flying spaghetti monster to exist, but I have no proof whether it does or not.

* bows

<Lovitz> Thank You! </Lovitz>

Good one, Ken!

Stop it, stop the posting madness!

Yeah, this thread and the Collaire Report have been "on" today. This goes straight into the diary.

"Dear Diary: today I engaged in witty repartee with Sean and the guys. My plan to drive Ken insane appears to be working..."

(diary, continued)

"My quest to rapidly make it to page one of the top posters also is moving ahead full steam"

You got only 7000 posts to go to catch up to me, bucko.

"I have recently passed craigsub and am ready to crack the top 30. Sushi is in sight. If these sherpas would move a little faster, then I would probably be having even better success..."

That's what she said! (from one pornstar to the other)

"Ken appears to be reverting to comic book machismo slang to throw me off. His defenses are primitive and should be easy to overcome."

Bring it...
<waves hands in vaguely threatening manner>

"Dang, it's quitting time. Would that I were on PST so that my epic adventures with these folks could continue a while longer. Alas, that is all for today. Off to the post office I go, and I shall see you later."

(that's both a threat and a promise)

But if you were a PST-ite, then you'd start posting three hours later. You'd have to be a daily bi-coastal commuter. But then, your life would pretty much suck, unless you got to know a flight attendant really well....

Just covering all the bases, huh?

Didn't Daily Bicoastal Commuter get into a bar fight with Negative Orange back in the 90s?

I don't know, but I bet CV has the newspaper clippings to prove it.

For the luv of mankind! Adminsitrators! Please lock this thread!

LOL

LOLz R gud 4 getting me going in the morn.

I think all my posts 2day will B txt style 2 try n wear Ken down a bit.

c ya

I will avoid your pathetic grammar and spelling merely by being on a 3 hour flight.

... a 3 hour flight ...

Gilligan, updated for the 21st century ...

Get back to work, you!

Didn't the guitarist in Negative Orange come from the new wave band "Back to Work"?

I don't know, but I bet CV has the haircut to prove it.

Ha! I could keep this up all year, Sean - you?


Now that is an invitation for Photoshopping if I ever heard one. Would that I were skilled in the ways of digital image alteration. Why, then, I'd take that picture of CV with Vagina Speculum Regina Spektor and treat him to a new hair-do.

Absolutely. The real question, though, is can everyone else put up with this all year?



I am a huge fan of the Marx Bros.

Mmm, Logan's Roadhouse for lunch today. Drug rep told us to order whatever we wanted. Steak and ribs for me.

Sean, didn't Logan's do the catering on the last Negative Orange tour?

I don't know, but I bet CV has the bib to prove it.

Good lunch today. The brownie with ice cream is not going to help me lose weight, though. Heck, my lunches are not going to help me lose weight in any universe except the Bizarro one.

Maybe you should consider different types of lunches.

What, no SB today?

I know, right? You'd think I'd know better.

Well, I do know better, but I don't choose better.

Doctors.

You forgot the *shakes head ...

or the now-famous *sigh

Yes, I've borrowed his *sigh* on many occasion. Must give the proper credit.

Yeah, I was kind of distracted. New laptop here at the office, can't wait to see how awful it is.

*Sigh*

*shakes head*

Yeah, even if it is to Ken.

New toy for Ken!

Ken, I'm told they don't mind if you take your new laptop and break it down for parts. It's just there as a junker.

Nah, it's not mine. I don't really want it, I already have 2 powerhouses, one of which is nominally portable. This is an X300. I halfway hope it sucks so the people who picked it out sight unseen will have their noses rubbed in it, and halfway hope it doesn't suck, so my end users aren't miserable for the next 4 years.

Jeebus, don't you guys -- you know -- work during the day? At this rate, Ken will pass me by the end of summer and J.P. will outdo both of us next year sometime.

Have a look at Mojo's rate of posting--he's very likely to pass us all.

100th post in this thread. Woo!

Take a look at the last time he posted, He won't be passing anyone anytime soon, unless I find someway of dragging him back in here again, he has called it quits.

What happened?

Oh my.

I often didn't agree with him (and posted to that effect), but I did enjoy his posts and his company.

He found himself doing more in here than actual work and as he is doing consulting work, he actually has to show results to get paid. It has nothing to do with the forum or Axiom.

That's something of a relief--glad nothing's wrong with him and he's not pissed at us as a group.

That's too bad. I enjoyed Mojo's posts and my interactions with him.

I hope he finds the time to pop in every once in a while.

Speaking of getting work done, it's getting near the end of the day for me and I need to start accomplishing things. . .

That was the problem he really liked it here, a little too much I guess. I know how he feels, I have finally stopped logging in here while I am at work, hard to fix trucks when typing and reading the forum. Now I just have to cut back to a few check ins a day while at home, so I can accomplish even more here.

I use this forum as a medicinal way to get through boring conference calls. I'm an excellent multi-tasker so I have never been caught not paying attention.

What did I just say, Murph?

Ha Ha! Good one.

Word in the office is that we're getting soup and salad for lunch from a new drug rep.

I smell the meddling hand of Ken, I tells ya.

Ew, I wouldn't want to smell Ken's hand.

I washed them.

Two weeks ago doesn't count.

Soup smells good. This may not be a total loss.

*wanders off to break room

No wonder meds cost so much. Add the cost of a free lunch to each pill...

Yeah, I get a kick out of how little old ladies in Luray are paying for my paninis.

Seriously, it does come to mind a little. The rationalization is that information does get exchanged, I get a chance to ask questions and learn from them while they try to market to me. They also drop off samples that I give to needy patients.

Actually, a much bigger factor in drug costs is the direct-to-consumer advertising that is everywhere. That's where the lion's share of their marketing dollars go.

"Do you sometimes feel down, or tired, or hungry? You don't have to deal with these so-called normal emotions anymore. Ask your doctor about Wellbutrinialisloft - an unselective everything-uptake inhibitor... after all, who do you trust - this commercial or your family physician? If he doesn't give you a prescription for it, call him a quack and see new doctors until you find one that's our b!tch and a glorified drug pusher. Side effects are many and have nothing in common with placebo tests including death, near death, fatal death, and expiration of life. Wellbutrinialisloft is not for everyone, some people with conditions such as poverty should not take Wellbutrinialisloft. Isn't your life worth not feeling highs and lows? Keep a steady keel with Wellbutrinialisloft - the lobotomy in a bottle."

Bren R.

I prefer "consultant" or "member of the speaker's bureau" to b!tch, but I say potayto, you say potahto ... I am currently chewing on whether to continue in this respect. It's good money, but just a small fraction relative to my practice revenue, to keep it in perspective. If I thought it was compromising my decision-making regarding patient prescriptions, I wouldn't do it. There have been opportunities to work with medications and companies that I think are not worthy, and I've turned them down.

Dan Carlat, MD has a nice blog in which he speaks of this topic, especially as to how the drug companies have undue influence over continuing medical education (CME). There's a bill in Congress that hopes to out the b!tches. link

Think you misunderstood me, J.P. - I wasn't calling you a pusher... but every city's got "those doctors" you know you can go to to get whatever prescription you see on TV and like the ads for.

I don't get the feeling you would intentionally push a pill on one of your wac... er, patients just because of kickbacks.

Sorry if you thought I had my eye on you.

Bren R.

In medical school, we were warned about this local doctor who saw people for two conditions: back pain and sleeping problems.

It was so obvious that he fit your description, it was to the tune of being greeted by the receptionist thusly: "Are you here for back pain or insomnia?" Therefore, the patient was able to select his Rx du jour.

I didn't think that you were looking at me, but in the interest of full disclosure, I figured I'd lob my info out there anyway. Gotta keep a clean conscience. Well, as much as possible.

's OK, Brother Bren.

I hear that the little old ladies from Luray have some caverns in the basement.

Yeah, theys got cobwebs down thar too.

But do they have arsenic?

No, but Pee Wee Herman's bike has been sighted.

From the "Should I or should I not share this with the group?" File:

In college, I had a maroon three-speed bicycle that had old-fashioned handlebars. It was close enough to Pee-Wee's that I got teased in that fashion quite a lot. I was able to roll with it and perfect his laugh.

For the end-of-the-year slideshow during the dorm banquet, I took some pics of my bike parked in front of some campus landmarks. It was good for some laughs.

Now pardon me while I go to the local cineplexxx for a quick afternoon matinee ...

As long as you're sure it was the bicycle causing the teasing.



For your daily gooing off?

1. I'm sure.

2. Exactly.

Yay, I guessed right. What do I get? I'm totally not scared of the prize.

. . .neither is his wife.

She did marry me, after all ...

Is that after you clubbed her on the head and dragged her back to your cave?

Your such a romantic. . .

I hypnotized her with the rainbow head.

Still haven't figured out how to get her to stop clucking like a chicken.

Well, marraige is all about compromise, right?

Yeah, and we can use the eggs.

ba domp psht

That link'll come in handy!

Funny story about that... a buddy and I were doing some "report clay shooting" a few years back... 25 clays in a row, every time the thrower hears the shot (the report) he throws the next one... a real test of manual dexterity with a pump-action shotgun: load-sight picture-fire, repeat 25 times.

"You're pumping that thing like Pee Wee Herman in a p*rn* theatre!"

Bren R.

<Pee Wee> HA HA !!! </Pee Wee>

While we are on the topic of harrasing mental health workers....
Actually Peter this won't even be targeted at you.

This morning on the radio I heard an interview with a gal running a call center. She was spouting off about how great it was to work there and that they just started a new employee assistance program. "Free counseling is now available to all employees, 7x24, by phone."

Soooo, call center employees who need counseling, are going to call another call center??? I think if anybody knew better than to call a call center, they would.

I can hear the automated IVR now.
--If you suffer from clinical depression, press 1.
--If you suffer from extreme anxiety, press 2 repeatedly.
"Beep"
-- Thank you for choosing our clinical depression service. All of our operators are currently busy. If you feel suicidal during your wait, please press 0 to talk to an operator.

I've worked at a call center (kinda). It's a miserable job. At least we were just taking calls for orders, but eurch.

Ken, there is medicine available for hairballs.

That's good. The food formula tastes terrible.

mmm, Catlax ...

While Googling, I came across the Catoctin Youth Association Lacrosse (Lax) League and their unfortunate moniker.

Catlax.

No drug rep lunch today, and I forgot to bring one.

Hmm, fast food it is.

Although the local supermarket has a guy that makes sushi. Might have to try and be a little healthier, thanks to the cajoling of my Axiom buddies. Hmm...

And I guess the rainbow head is retired now.

Good old Sigmund Freud has taken his rightful place as the avatar of choice for the discerning psychiatrist.

I saw in the users list that sushi's avatar has been replaced by an asterisk. Was this to avoid brand confusion with my duplicitous shenanigans over the weekend?

And, for those who don't know, my new sig is from the Tom Pety song "Zombie Zoo", off Full Moon Fever. I would have indicated that, but I'm at 100 characters as it is.

Great song about emo teens, posers, teen angst, etc. Set to a deceptively boppy beat ("Sha-la-la-la") ...

Does that mean The Soosh is watching?

soosh? what?

Soosh = sushi

Ken has pet names for all of us.

Yours is sh!thead...

Today, apparently, mine is a$$hole!

I heard it was Dr. Sphincter.

"Ass sphincter says what?" - Wayne Campbell

Editorial: Come on, Monday, get on outta heeyah!

2.5 hours to go, I wanna be sedated ...

Only people who have young kids should know which band I'm quoting now:

"On Mondays, I never go to work."

I heard that over the weekend on my son's TMBG DVD. I forget if it's the ABCs or 123s...

One of the most awesome things in his development has been to see him learn letters. "W" is his favorite. We presume that's because it's in the word "yellow", not because of politics.

We only have the 123s video. My favorite songs are Nonagon and Triops.

Did you know that "Triops has three eyes, Triops has three eyes ..."

We should get Ken one of those DVDs. Now those songs would stick in his head!!!

I'd rather have that stuck in my head than "Baby beluga in the deep blue sea..."

Next time TMBG comes to DC or Baltimore, we should go.

I'll build a birdhouse in my soul for that.

Wonder if they've ever sung in Istanbul/Constantinople?

No, but since everyone's your friend in New York City I hear they favor performing there.

Is it true that they were a major musical influence for Negative Orange?

I don't know, but I bet CV has the geeky band friends that fight about it all the time to prove it.

Yeah, like the ones that can recite the lineage of Yes, Genesis, etc. Like my high school friend Beau Dure.

I'd trade my prosthetic forehead that I wear on my real head for TMBG tickets.

Bren R.

Don't let's start making TMBG references. Oh, we're already 32 footsteps down that road.

You may be... but I'm in a Road Movie To Berlin... and I can't get out the way we drove in...

Bren R.

Are you sure you're not on Toddler Hiway?

Heeyaaa!

Quiet down, Peter! Man, it's so loud in here ...

I was kind of wondering what the Xanax wall plate looked like, though.

Needs a blue light to complete the effect.

Thought you tech-lovers would appreciate this story:

----

By JAY LINDSAY, Associated Press Writer Fri Jun 13, 10:44 PM ET

CAMBRIDGE, Mass. - Researchers at MIT believe they've discovered a new weapon in the battle against tuberculosis: Free cell phone minutes.

For years, doctors have struggled to get some TB patients to take all their medication, which generally involves a six-month regimen of multiple drugs.

Now a student-led group at the Massachusetts Institute of Technology has developed a way to use cell phones to let patients test themselves. And if the tests show patients are following doctor's orders, they get rewarded with free minutes.

"We're piggybacking on one of the bigger rollouts of infrastructure out there, which is wireless technology and telecom technology," said Jose Gomez-Marquez, one of the project's leaders.

The system works like this: Patients test their urine using a strip that reveals a numeric code if it detects TB medicine. They then text message the code to their health care provider and get credit toward incentives such as free minutes.

The in-home tests also eliminate the need for health care workers to make several patient-monitoring visits a week, a routine that is often impractical in remote places, Gomez-Marquez said.

Mobile phones are good tools for the project because they are common in the developing world, where it's often cheaper to erect cell towers than miles of poles and wires, Gomez-Marquez said.

----

Full story, including critique/analysis, here.

Of note to those in the Chicago area, I will be in your great town ever so briefly this Friday night.

I'm going to a conference Saturday; the company I consult with is flying me up Friday at noon and back here Saturday evening.

Looks like I'll be at the Art Institute of Chicago for Friday night fun - it's open 'til 9 pm.

Off the top of my head, I don't recall any Chicago playas on the boards, but if I'm missing someone to wants to meet up, or if by some odd stroke of luck someone else here will be traveling there at the same time, I though I'd lob this out there so you could send me a PM if interested.

I'm 6'4", brown hair, brown eyes ...

The drug rep was late with lunch today - office natives were getting restless - but she just showed up with barbecue from Red, Hot, and Blue, so all is well.

Ken, no word on the emotional status of the Olive garden staff today. I hope they're coping.

That is all. Carry on.

So it's all just a racket to get free lunches and to pay for the schooling that gave you the skills required to set up a shop to get free lunches.

I see how it works.

Oooh i'm behind on posts but with this one Peter, i have to agree 100%.
That damn beluga just won't die like the ones' at Marineland.
I think the dog is going to find that disc in her play toy box realll soon.

OK, so here is a cute story about my almost 3 year old son.

He was playing in the living room when my wife put on a CD. After a while, he said, "Mommy, I like Daddy's music better."

"Oh yeah?" she answered. "What kind of music do you like?"

"I like RUSH!"

"Really? Are you going to play music [an instrument] when you get big?"

"YEAH!!!"

"What are you going to play?"

"Drums!"

That's my boy!

That would make my day. Quite a heartwarming story for me a fellow Rush fan. I see my 15 month old boy (Matthew) dance and drum his hands whenever music comes on. I have wondered if he will want to play drums or another instrument too.

I don't buy it. That was rehearsed.

Nah, I had only vaguely told him who the band was, and he discovered the joy of hitting things on his own. He's a sharp cookie!

Anyway, I was browsing the interwebs and I typed my name into the URL bar to see if a domain was available. It was not, and I found my doppelganger from the Philippines.

www.jpswing.com

Do his future bassist a favour, and buy him a metronome... NOW.

Bren R.

Cool Bren, I will!

Hey, did anyone else see Rush on the Colbert Report?

Their first American TV appearance in 33 years!

Don't worry if you missed it - here's the links for the whole episode, courtesy of ComedyCentral.com and your friendly Rush fan, medic8r.

The full episode

Down on the page, you can pick individual parts. Before they do Tom Sawyer, there's a funny interview. Good stuff, although the show ends before they can finish the song...

I'm behind on my episodes. but TiVo has it ready for me!

By the way, JP, Spin has a piece on Juliana Hatfield in the August issue. She's looking well.

I did catch Rush, I was flipping channels and stopped once I realized who it was.

Wheee!

medic8r manor has finally entered the 21st century, or at least caught up to the nineties. We now have broadband at home!

We still are too rural to get DSL, and the cable company balked at running cable down our long driveway. So the answer was HughesNet/DirecWay satellite.

Sure, the speeds are tame (1.5M down, 256k up) compared to DSL, cable, and don't depress me with FIOS. But, since I previously perused the web at 40-44K on my V90 dial-up modem, I feel like I'm living large now.

Mrs. medic8r presided over the satellite guy this AM and the Geek Squad this afternoon. We have a router for a home network. My wife's MacBook, of course, was pretty much ready fro mthe get-go, and my Dell PC has some sort of USB receiver thing on the back now. Pardon my technobabble.

Geek Squad apparently did a good job (whew). They pulled up, of course, in the VW Beetle, and the guy introduced himself as Double Agent Smith (or whatever his name was). Apparently this is the what they call themselves in the field. The telephone operators are agents and the service call people are double agents. Ooh.

Anyway, hopefully I'll see you guys around a bit more in the evening now. Salut!

Uh-uh... Incoming posts! Raise shield!

There's no stopping J.P. now!

<Superman>I'll stop him!</Superman>
<Fists on waist, elbows akimbo>

Ken used today's magic word:

Akimbo.

I think one of my characters was named Akimbo. One of my millions of unused characters who only have different names, not different personalities.

For fredk, here's today's lunch report:

The rep brought us chicken salad wraps from Costco, so that was pretty cool. I like just about anything from the Costco kitchen. It was accompanied by a bag of Cheetos and some lemonade.

The rep pushes Luvox CR, so she's got a tough sell. It's just an old drug in a new package. There's not much reason to prescribe new, branded, expensive Luvox CR instead of the original, generic, cheap Luvox. Or one of the other SSRIs that has less side effects and is just as powerful and cheap.

Wouldn't want her job (her commissions probably suck), but I appreciated the lunch.

Mmmmm. A cut above mangled french! Except maybe the cheetohs.

I often wonder what those reps make.

Hmm. Just looked at my avatar more closely and saw a pair of boobs under the mouth.

This would make a good Rorschach ink blot.

That's really disturbing.

LOL, seems like most of my posts these days contain something amusing and/or gross, and most of your posts are one-liner follow-ups to point out the disturbing aspect.

One of these days I'll slip one past you, or better yet, get you to laugh at it without comment on the dark side. Mwah ha ha.

Doubt it.

Tomorrow I'm going (with mrs. medic8r and medic8r jr.) to D.C. to some museums. We'll probably spend most of our time at the Museum of Natural History. Last time, Nolan really loved the animal exhibits. If the weather cooperates, we may head over to the zoo. Even though we got 3.5 inches of rain in about 18 hours as Hanna's remnants passed through, I hear it may be nice tomorrow.

Of note, we hope to meet up with a college friend of mine. Tom and I lived in the same dorm all four years (that's how it's usually done at ND, which has no Greek system), and then years later, we both were in psychiatry residency together. After serving his four years in the Army (they put him through med school), he decided to become a priest, so he is in seminary through 2010. I just found out when I met up with him on Facebook. I hadn't had contact with him since residnecy ended in 2001, and then I find out that he's in D.C. for seminary for the next couple (and last couple) of years!

I'll make sure to ask him what kind of school or program he'll look for once seminary ends. Of all my friends, he did seem like the kind of guy to be a professional student. I mean that in a good way. He's so inquisitive and likes knowledge for knowledge's sake. Thank God (?!) there's still people like that.

It's nice to see they changed the spelling to 'seminary' after all that hoopla a few years back.

Wow, what a beautiful day. The weather is perfect. All the plant life is happy to have had some good rain for the first time in a while.

Mark, you're missing some great natural lighting. At least you'll be able to listen to that Dave Matthews DVD soon.

JP, harsh sunlight isn't the best lighting for photography, at least according to my brother.

But, it is a wonderful day. I wish we could be at the museums with you today.

Hopefully it'll be cooler today. It's been roasting for the last few days. Gah.

Well we are at a balmy 52 F so you could do a road trip up this way to cool off

What, no snow yet? I would have thought you would have your igloo up by now.

I'm going to hijack Doc's thread to say that I plan to leave CV's latest comment in the shout box hanging as long as possible.

I guess it's up to me to send my own comments up the river.

Had a nice time at the Smithsonian National Museum of Natural History. My friend Tom looks exactly like he did 8 years ago. You think he's sleeping in a hyperbaric chamber, perhaps?

Nolan liked the dinosaur skeletons, of course. He was proudly wearing his Pterodactyl t-shirt. He recognized the Triceratops, Stegosaurus, and T. Rex. I spent half of the day answering "What's that?!", but I ain't complaining.

The chow at the cafe behind the dinosaur exhibit was not half bad, especially for previously prepared cold sandwiches. For the beer thread aficionados, they even had Heineken and Amstel Light, $5.50 a bottle, what a bargain!

Peter, I almost PM'd you to see if you and the family were free, but I figured with such short notice, the force was against me.

Welcome back, tit-face!

(this post will be very strange next month.)

I'll have to get a facial tattoo so that people understand.

You're luckey to be so close to the Smithsonian! The Natural History Museum has the most amazing fossil collection I have ever seen. Very nicely organized.

I would love to take my son. He's still big into dinosaurs. Not sure if a 10 hour drive is quite worth it though.

I'm looking forward to pics of the face tatoo.

I was going to highly recommend Dinosaur National Monument--until I remembered they'd closed the visitors' center.

I remember going there as an older child, and being absolutely fascinated. I love natural history museums and the like. LA has a great one, too, and there's always The The Tar Tar Pits for those of us lucky enough to live on this coast.

Ken, your Jar Jar Binks fascination has reached an all new low. . .

pity

And I didn't know he was a big fan of The The, either.

Ken's a man of mystery.

There are lots of cool places to visit if you have the time and the money. Dinosaur National monument is in Utah isn't it? I visited there in the late 70s.

Everywhere I want to visit would end up with me being arrested for stalking.

Colorado, I believe.

The The Tar Tar Pits actually is The La Brea Tar Pits in Los Angeles. Cool museum, complete with a tar lake in the middle of LA! Right near the Petersen Automotive Museum, which is also worth a visit.

Otherwise known as the 405. . .

Dude, this is a family forum. Put some pasties on!

What, no tasles?

Originally I was going to do "rings", but there just aren't enough pixels there to make them really noticeable unless they looked like huge hoop earrings!

LOL at Mark.

I'm going to try and see if I can get one of them to swing clockwise and the other one to swing counterclockwise, with tassels.

Here goes ...

...

...

Success!

Cue up the appropriate Tom Waits song.

http://www.last.fm/music/Tom+Waits/_/Pasties+and+a+G-String

(click the play button near the upper-right)

I just wanted to see that line again.

The Smithsonian is the greatest museum in the world. It's free. And you can get a beer there.

God Bless America.

Is the beer free too?

No. $5.50 for a bottle, according to JP.

Today in J.P.'s Office, I've decided to share with you all a couple of cereal recommendations.

Optimum Power is one of my favorites as far as healhty cold cereals go. Gotta love that high-fiber content. Makes me feel slimmer after every meal. Until I get to work and eat drug rep lunches. It is actually pretty good tasting, though it does suffer a little from Twigs-Bark Syndrome. *For some reason, this window resizes your browser*

From the same company, there's Optimum Rebound. It is definitely tastier, but has lass fiber. I have yet to try it after working out, as they suggest. If I ever exercise, then I'll eat some cereal so I can report back on that.

These are available at most grocery stores in this area. YMMV.

Yeah, I don't know if that's going to be compatible with my system.

I can just see Anthony Hopkins in the next Nature's Path TV commercial... "Now featuring lass fiber... Aye, she was a fine lass, she was... A great breakfast with a nice espresso"

Ewwww.

Dr. JP Swing: Head Shrinker and Nutritionist.

Have you had your lass fibre today?

lass fiber... heh. JP must have had a video he recently saw on his mind.

*chuckle*

or my avatar, I guess.

again, this will be cryptic to those who read it after 20 or 30 avatar changes.

Yesterday I was out of the office. I went along with a drug rep to be a visiting speaker for an ADHD medication. We drove to doctors' offices, where I would answer questions and talk about my experience with the medication. I said it was delicious and went well with chicken fettuccine from Olive Garrrrrden.

One of our stops was this practice, not far from where Peter lives. Small world. So, Peter, if you felt any disturbances in the force yesterday, this may explain them.

What's your Frequency Rep. curve?

Well, the lunch was catered Mexican food, so I imagine my backwards-facing woofer peaked at about 40 Hz.

I found the canine version of Jackie Chan!

I suspect the other dogs put her up to it to have more room!
Pretty impressive for a dog!

What's he doing in my office?

I like dogs and all, but ...

On the way, we decided to stop off for a coffee. Man, that is good! We decided a couple of donuts would be better yet...help the coffee go down. That made me realize I'd better call the wife and tell her I used the last of the milk. Was that waitress just checking me out? Look...someone left a paper. Hey, did you see that story about that kid? Mmmmmm....coffee.

Now what were we doing in this part of town?

I was going to write that post, Mark, but I got distracted. Plus, it seemed like too much work.

What post?

SpidyDog SpideyDog
Does whatever a ...........
SpideyDog can

Mmmm ... barbecue today for lunch.

Yup, another valuable post by yours truly...

*rubs knuckles on chest*

That's going to leave a stain.

D'Oh!!!!

I thought I should spend some time in J.P.'s office.

See, I do learn things from reading video game blogs:

Reflectoporn - Wikipedia, the free encyclopedia

Ignorance is bliss...

Note to Axiom::: You are no longer allowed to ship CV any speakers with a high gloss finish.
.

J.P.'s South Beach diet continues for the fourth day. Having purged myself of carbohydrates, I am thirstier and drinking more water. Haven't had a soda in a week. Occasional tea or coffee with Equal.

*sigh, no Starbucks, no donuts, no Olive Garden*

I brought lean chicken in case the drug rep brings carbs for lunch.

Cool. Then you can smother your chicken with them.

You are an inspiration!

I'll take you at your word, especially since, true to form, today's drug rep lunch was ... Olive Garden. I only ate the salad, no dressing, no croûtons. I skipped the chicken fettuccine and ate my baked chicken from home.

Now for more tea. It's Twinings English Afternoon this time.

<Inigo Montoya>Who are you?<Inigo Montoya>

I just got back from a drug rep lunch at my wife's office.. some Italian place, pretty good fettuccine. They were pushing a drug right up JP's alley, Cymbalta (duloxetine)used for depression and nerve pain in diabetics.

Ah, Eli Lilly strikes again. Our Cymbalta rep is so hyper that he gets annoying real quick. Hi (your name) if you're reading this. I won't put your name in lest Google send you here one day. Boy, would that be embarrassing!

Even Michael gets drug rep lunches!

I'm serious, JP. That's awesome.

I think we should use this site to generate avatars for next month's theme.

http://turnyournameintoaface.com/

I second the motion.

All in favor? (*pretends to hear many "Aye"s*)

All opposed? (*pretends to hear a few "Nay"s*)

So be it.

I'm getting an early start.

I say the true avatar is what your screenname generates, but I'm sure some of you will rebel and come up with others.

Here's mine, with variants:

medic8r =

J.P. =

J.P. Swing =

I've tried some y'all's screen names, and I like wid's the best so far, although my alien is pretty cool, I must say.

wid =

Most of mine looked like serial killers, other than the fat one. Ferget it.

Yeah, what's the deal with kcarlile's dentition, and Ken Carlile's total lack of hair?!

Man, I won't be able to see anything until I get home. . .

Hey Sean, I just ran your names through the mix.

No pix as I'm too lazy, but verbal descriptions are within the spoiler tags.

I figured since I sainted my user name I'd come off pretty good.

Can't wait to get home.

I am so emo now.

dooooooood.

you wanna hang at the mall l8r?

if that fat security guard ain't there, we can totally thrash our boards on the rails and stairs and stuff....

Isn't it still October?

What with the election in early November, we figured we'd switch now before we were distracted by exit polling.

I think my web generated face has turned me into Bren....

Can we call you Pat now that you have a Brenatar?

Oh, damn you... I was sipping Pepsi.

Bren R.

Good one CV.

LLLLOOOOOLLLLLL, That one makes the highlight reel.

I'll play along.



Ouch.

Bren R.

Looks like Cyndi Lauper ran in to Gene Simmons, Tina Turner, Captain Kirk and Sara Palin and became.........Brenatar.

I want that out of my head RIGHT NOW.

C'mon. Please?

Okay.........done. Gone yet?

Uh. . .ew.

Bren, you don't make a good looking lady.

Yay, I'm credited with a good one! And I'm not even to 3000 posts yet!

Your wife isn't the only one, huh?

At least he has one.

I don't really feel like I'm missing out whenever discussions of WAF come up.

If I had a wife, I would definitely hope she didn't have a goatee.

That's the nicest thing anyone's said to me all day.

Bren R.

Sorry guys. I found this lion cub picture and just had to use it. I'ma stick with him for a while.

The mutiny has begun.

Flip-flopper!

First you're all gung-ho about the face generator, and now you've done a 180 and gone with a cutesy animal face?

Prototype3a, relieve the man of his Man Card.

I'll be right back after I put some beach sandals on the back of my car.

Hey! I thought I started the mutiny!

Tom, when the floggings begin, we'll be sure to include your name on the list.

Does that mean I jumped the gun on the self-flagellation?

*uncomfortable silence*

Sure, rub it in that I was born with cilia and not flagella.

Bren R.

I like Smurfs!

What do those drug reps put in the food, anyway?

Bren R.

Possibly little blue pills....

The Matrix again?

Thread reply #300. What do I win?

Little blue pills.

Speaking of avatars, I kind of miss "South Park" Ken.

Metallica shirt-wearing South Park Ken was pretty kewl.

JP - nice choice on the new avatar.

Jason

Hmm. I had almost forgotten about that. I'm afraid I'll probably have to go back to photos of my son, though.

Just a quick plug for my blog:

MEDIC8R MANOR

Come see what I do when I'm not lurking these boards...

People should use RSS readers and subscribe the websited/blogs they visit most often. Then you don't have to guess if there's any new content, or rely on self horn-tooters to announce it....

Self horn-tooter, wasn't that what Negative Orange's last tour was called?

I thought we already decided that Neg O's last tour was called Still Beatin' It 'Cuz It Ain't Dead Yet.

Oh right, Self horn-tooter must be the upcoming tour.

Uh,

What RSS reader should I use?

Google reader is free and easy.

http://google.com/reader

P.S. Sean, I stopped liking Smurfs last month, remember?

History repeats itself. (Not necessarily saying you're history.)

Okay, I change for you.

The Accommodator strikes again!

That reminds me, I still have to think of a new one.

Oh, the pressure is killing me!

Or it's making you stronger.

Stronger smelling.

I've been too close to JP's socks.

You know what he wears his socks on, don't you?

Ha ha. . . . . . . ew.

Nice blog, not sure if Vyvance is available up here, any data vs Adderall xr and sleep patterns?

25mg weekdays and 20mg on weekends.


Oh, and does it have the same reaction when you take Sudafed without thinking...

I'll send you a PM.

Mrs. Medic8r has commented on the blog. She sends hellos to everyone. Well, no, just Tom and Peter, actually. I boosted her hello signal to everyone.

Does that involve fiddling with her knobs?

you KNOW what's coming.



wait for it.......


:::runs away crying:::

STILL a hilarious classic.

Mark, we've still got to meet up, and then she can say hello. You pansy.

CV, LOL.

I thought you only wanted to meet up if I got you Red Sox box seats?

Well, that's a start...

Yeah, and apparently I'm only meeting him if he can get me backstage with Regina. What's wrong with Mark that he has to bribe us?

<---- This used to be my Avatar....

Another satisfied patient.

Chalk another one up to the powers of medic8shun.

Hey, Medic8r Manor now has a Wii!

We're connected to the internet, and I have a "Mii" = medic8r. Now I have to figure out how to meet up with you guys online. There's a thread here somewhere that I'll search for soon.

Going to Cracker Barrel for brunch now - yum.

Hey, MarkSJohnson, check this out from my Facebook page:

"Green Day will appear on the May 16th season finale of Saturday Night Live as the musical guest. Don't miss it!"

Also:

"Green Day have announced that they will hit the road for their first proper tour of the United States and Canada in more than three years beginning July 3rd in Seattle, WA. The first leg of the tour will cross North America through the summer and finish up with a show in Los Angeles on August 25th.

July
3rd Seattle, WA
4th Vancouver, BC
6th Edmonton, AB
7th Saskatoon, SAS
9th Winnipeg, MAN
10th Fargo, ND
11th Minneapolis, MN
13th Chicago, IL
14th Detroit, MI
16th Hamilton, ONT
17th Ottawa, ONT
18th Montreal, QUE
20th Boston, MA
21st Philadelphia, PA
22nd Pittsburgh, PA
24th Hartford, CT
25th Albany, NY
27th New York, NY
29th Washington, DC
31st Nashville, TN

August
1st Atlanta, GA
3rd Tampa, FL
4th Miami, FL
5th Orlando, FL
7th New Orleans, LA
8th Houston, TX
9th San Antonio, TX
11th St. Louis, MO
12th Kansas City, MO
13th Omaha, NE
15th Denver, CO
16th Salt Lake City, UT
18th San Jose, CA
20th San Diego, CA
21st Las Vegas, NV
22nd Phoenix, AZ
24th Sacramento, CA
25th Los Angeles, CA"

grr. Nothing East of Quebec!!!

Although, I'm pretty satisfied since Friday. I picked up tickets for AC/DC coming on August 6th!!!!! Now, if we could get just get Greenday to open for them. They are in Orlando on the 5th so at least they are on the right coast, although still not likely.

Seriously, shouldn't that be the other way around? JP, can I hear you testify?

If they were coming to a particular "local concert venue", I would offer to shoot again. Last I heard, they haven't found a replacement for me yet.

I'm not surprised.

I'm very, very special.

AAAAAA-MEN!

How was that?

And we all knew Mark was special, ever since the days of the short bus.

That's Filter, not Green Day.

Oh, wait.

I get it.

Hey, this patient of mine just told me he got a Nikon D700. I resisted the urge to follow him to his car and wait for the meds to kick in, then - FREE CAMERA!

:runs away with FREE CAMERA!:

You a thief? I shutter to think of it...

I need to find a cartoon generator that allows custom pics added in. I'm envisioning Medic8r talking to a Stormtrooper.
"These are not the Meds you are looking for......"

You are lucky to get tickets. Tickets for the Vancouver show at B.C. Place sold out last Saturday very quickly (50,000 plus). My friends tried all morning to order tickets through ticketmaster. When they finally got through, the upper level tickets were all that was left I was actually looking forward to seeing them.

*bump*

It's been quiet around my office lately.

I thought this would be a good place to post this: 10-worst-LOL-sites

Safe for work.

*blows dust off of thread*

Since the move from Virginia, I've left the private practice world to work for the state of Georgia. Should have done this years ago. The hours are better, and I don't have to run a practice. I just show up and see patients. Plus, there are the benefits of insurance, sick days, and getting paid the same even if patients don't show up.

Minor write-offs include having to work for someone, but then, the Medical Director is an old friend of mine. Also, not having to run the practice means not getting to run the practice. There's the red tape of state government, but for the most part, things make sense, and the people work well as a team.

I split time between two offices. They are in Waynesboro, GA and Swainsboro, GA. This is small town America, fer shur.

Tom, lunch today is leftover taco meat and cheese. Gonna nuke me a quesadilla in the microwave. Better than it sounds - Gail makes great New Mexico red chili tacos.

But enough about your wife's taco.

Ahh, I never really knew what the move was about. I'm glad it's going well for you.

Glad to hear the move is working out for you.

Sad that the Axiomite density of the DC area decreased, but happy to know your relocation has proven positive.

I like Mexican food.

I like Mexican Food.

I like JP.

But seriously, not together.

Good to know I never had Mexican food when I was with him.

Is it all the obscure vegetable festivals that sends small towners over the mental edge such that a government institute is required in both towns?

Good one.

What if I'm too weak to open the tab? That yoga class really took it out of me.

Tom, that one is really good!

I overdosed and am now trapped in a ball pit made of my own flesh.

Dear lord, that's disturbing.

Indeed!

I think that calls for a cartoon.

I'm not touching that one. I'm afraid what types of web pages it might end up getting linked to.

Ain't it the truth.

Heeeeee's CA-RAAAAZY!

Says the former King of Spain ...

What's that sig line from, anyway? I'm too lazy to Google it.

It's a line from a Moxy Fruvous song.

A really good Moxy Fruvous song, although the a cappella version is the best.

And yes, I was hoping someone would notice that juxtaposition.

Today's horoscope sounds ominous:

This has been coming for a while, and you're not ashamed to say it. You've just about had it with your current situation, and you want out. Still, you're reluctant to make a move without something solid waiting for you. That's not a lack of guts, either -- it's a sign of maturity. You can buckle down and stand the situation for a few more days. At least until you've made some phone calls to start the ball rolling.

On a lighter note, lunch today was from Moes' Southwest Grill, make your own fajitas (steak, chicken). I ran late seeing patients and the guacamole was gone by the time I got there. O! the humanity!

The AstraZeneca rep says that a new indication for Seroquel XR is coming out next week. She didn't say exactly what it was, but that it is in the realm of depression. Since they already have an indication for add-on (adjunctive) treatment of depression, that must mean that they have succeeded (on their second try) in getting an indication to be monotherapy for depression. I knew, via my favorite psych blog, that they had filed an application for this, and for treatment of anxiety, with the FDA.

This is gonna be controversial. The main reasons: metabolic side effects, and use of medications outside their typical realm. Seroquel was developed as an antipsychotic, and it is a good treatment for schizophrenia. It is in a class of medications that have been proven to also be effective for bipolar disorder. The main drawbacks of Seroquel (and most of its kin) are metabolic: increased appetite --> weight gain --> elevated blood sugar, elevated cholesterol. Plus, Seroquel can cause significant fatigue and sedation. As well as irreversible movement disorders of the Parkinson's type. Oh, yeah, and there's a tiny tiny chance of a severe and often fatal reaction.

Contrast this with the side effect profiles of the newest generation of antidepressants: Prozac, Zoloft, Celexa, Lexapro, Wellbutrin, Effexor, Pristiq, and Cymbalta. They are not perfect, but most people tolerate them just fine. And they're a world apart metabolically (except for Paxil and Remeron, which are weight gainers). They don't have the chance of EPS or NMS.

So, in my practice, Seroquel is not going to be the first medicine I reach for for a depressed patient. It won't be the second, or the third. Maybe the tenth. And there may be some people that it just clicks for, plugging into their brain just right. But just wait and see, for every one of those people, there'll be 10 others that got the med from somebody else and have gained 20 lbs unnecessarily.

Interesting to see some insight into how the process works. Keep 'em coming.

You lost me after "the guacamole was gone".

Just kidding. Thanks for the lesson!

Just thought of something else on the subject: cost.

Average retail monthly cost, off the top of my head:

Celexa: $4 (generic citalopram)
Prozac: $4 (generic fluoxetine)
Zoloft: $10 (generic sertraline)
Wellbutrin $50 (generic buproprion)
Lexapro, Pristiq, Cymbalta, Effexor XR: $100-150

Seroquel, Seroquel XR: $300-500

Good god. That's just insane.

But that's what it's supposed to help with!

You need the medication just to take the medication!

No drug lunch today. Got to figure what I'll do. I think the local Chinese buffet wins. We'll see if I can follow the recommendations of this haiku:

"Eat food. Not too much.
Mostly plants." These are the rules,
by Michael Pollan.

Thats just depressing.

Yep. I heard a food scientist interviewed and when asked what he recommended that was pretty much it. The only differens was 'real food' as in not processed.

Ive heard (at least in mice) eat one third of the normal american diet you'll live a lot longer... bottom line you wear out the organs processing all the other .. less is more

You have time for this, but we are still waiting for you to re-cal your sub?

Oh sh*t busted! Im a mess, A have rack that goes from the master bedroom closet to the garage, ain't complete, opening in media room, aint complete .. I haven/t even told the guy that mows what to plant! Im a little spacey, never know what floats my boat on what day! today Im thinking the new ceton MCE tuner and how to incorporate that, and wait didnt I call SAturday!

I'm going to call a Dean and I'm just a lazy ass

Today's my mother-in-law's birthday. I think she is turning into the crazy old cat lady from the Simpsons.

No offense, CatBrat.

Speaking of cats. Have you heard about treating toxoplasmosis with drugs which seem to have an antipsychotic effect in schizophrenics? That is may not actually be an antipsychotic, but instead be fighting off the toxoplasmosis, which restores normal brain function. They say toxoplasmosis has no effect on healthy humans, but I'm not sure I believe that.

Too late.



No, but the better question is:

Can I "catch" toxoplasmosis from my cat?

Because cats only shed the organism for a few days in their entire life, the chance of human exposure is small. Owning a cat does not mean you will be infected with the disease. It is unlikely that you would be exposed to the parasite by touching an infected cat, because cats usually do not carry the parasite on their fur. It is also unlikely that you can become infected through cat bites or scratches. In addition, cats kept indoors that do not hunt prey or are not fed raw meat are not likely to be infected with T. gondii.

In the United States, people are much more likely to become infected through eating raw meat and unwashed fruits and vegetables than from handling cat feces.

Eeesh. I think I'll start scrubbing that tomato a little better. I don't play with cat feces, so no problem there.

I do remember from medical school that pregnant women shouldn't clean litter boxes due to the risk of getting toxoplasmosis, which can cause cysts to grow in your brain.

Uh oh.

When I used to have cats, I specifically hired only pregnant women to clean the litter boxes.

The more cats a person has, and the more time those cats spend outdoors, and the more times one empties a little box, the more likely they are to become infected.

I thought I read somewhere that it is estimated that 25% of the world's population is infected with toxoplasma gondii. (I hate statistics like that, because 75% of the world's population lives in conditions which would make them more likely to contract something like toxoplasmosis.)

I read on one site that it was 50%, but who knows about the veracity. Been a long time since I studied infectious disease.

The only reason I brought it up with you, is because of the thinking of some that it may be connected to some mental illness. Was wondering if you had heard anything on the topic.

My brother had a cat and he has schizophrenia. I have a cat and I don't have schizophrenia. So therefor the assumed schizophrenia mental illness rate from having a cat is 50%.

Or, would you prefer a larger test group?

Does your brother have a burning man avatar? The sample size just shrank by 50%, but the correlation is perfect.

Nope, sorry. He probably doesn't know what an avatar is.

Every one must know what an avatar is by now look how much that movie brought in I have yet to see it, if at all.

Yup, me either.

Me three.

Nope. He still doesn't know what an avatar is.

Why, you ask.

Because he's spent the last 5 years in a remote nursing home, doesn't want TV or newspaper, or any media to look at. He pretty much has resigned himself to waiting for Jesus to return.

Music?

Religious recordings only.

HOT.

Wanna buy photos?

In some, I made them wear hair curlers.

@ClubNeon: I hadn't heard about the toxo issue, but the web links I found after you brought it up were fascinating. In rats, it appears that this parasite changes the behavior of the host so as to further propogate itself. Amazing, mind-blowing stuff.

@CatBrat: that stinks about your brother. Chronic severe mental illness is no joke, I agree.

Hey, on a lighter note (avatar puns are fun), I found your cartoon stash online and thought this one was interesting:

There are quite a few brain parasites which do that. They excrete various neurochemicals and alter behavior in a way which makes it more likely for them to get passed on. This is probably the freakiest: http://www.youtube.com/watch?v=EWB_COSUXMw

Have to check it out at home - working for the man means no video at work. If they ever shut off access to the boards, I'll have to quit.

Nature is so disturbing. You're making it even harder to leave the house.

Where as my job description includes the monitoring of technology related forums to keep abreast of developing trends.

I shouldn't bring this up, but... One of the suspected symptoms of human males infected with toxoplasmosis is introvertedness, and agoraphobia. On the other hand, human females become extroverted and sexually promiscuous.

I'm opposed to "nature" but I know it's a losing battle.

I was just about to post this same comic, when I noticed that you had already done it. Now, I'm going to have to find a new source of comics.

Duuuude....JP is, like, ALWAYS getting into the stash.

Hmmm. I clean the litterbox every night, and have for probably 5, 6 years. I'm very introverted, and am generally starting to categorize myself as a misanthrope. Hrm.

Ever feel that the world exists solely for your own entertainment? After going on far too long about brain parasites, I promised myself I'd stop. But then one of the webcomics I read regularly posted this today:

So you're saying I should suggest that my wife clean the litterbox as part of foreplay?

If you both take turns, you won't want to leave the house, and neither will she.

We're renting in Augusta until we find the place we want to settle down in.

Tonight we will be looking at a 12-acre lot just outside of North Augusta, SC. My wife now wants to raise goats and/or sheep. I think she is getting back to her Bohemian roots. She is of Czech/Bohemian descent after all ...

I could deal with a Great Pyrenees to guard the flock. Didn't someone here just get one or two of those?

Anyhoo, this should be interesting; will keep you guys posted.

Real80sman and it was a cross with a Pyrenees,IIRC

Great dogs!!

You might also consider a Border Collie to take the herding to the next level, not that a Pyrenees would be bad at it either.

My Uncle has always had border collies on his farm and he trained every one I could remember to do amazing things. For instance, when he wants the cows in the barn, he sends the dog who opens the gate via a rope lever, herds the cattle through the gate, leads them across the road and up into the barn where he closes the barn gate with another rope and self catching latch. Never is even the most rambunctious calf ever missed.

Actually, His latest dog "Mack" has been my best buddy lately as I have been helping out on his farm once a week while my Uncle is in the hospital with Pancreatis and every conceivable side effect from it. There is one stall that I refuse to clean (Don't have the nerve) when his giant, award winning, Belgian stud is in there. He is more than happy to be led outside to the little fenced in area beside the barn for a while but going back in is another matter. He digs his hoofs in just short of the door and that's that.

Once again, with a whistle, Mac comes to the rescue. I just have to tell him, "Mac, put Jake in the barn." and in less than 30 seconds of barking and nipping at his heels, this 2000 lb monster of a horse goes inside and walks straight into his stall. Good Dog!!! Here's a pat and a milkbone for ya!!!

What I love most is that they are so genuinely happy to help. He will take the milkbone but you can tell the scritch on the head excites him even more.

Dude, you can scratch the top of his head, then keep the Milkbone for yourself.

Win-Win, I say.

Great stories, Murph. I'm always impressed at a good herding dog, or pig if you believe the movies. La la LAAAA!

In other news, the travel dates are set for my trip to New York City (all together now as the Pace Picante guys: New York CITY?!). I'll be there from 5/29 - 6/2 visiting with family. I've PM'd the wise old crow, Alan, to see if we can meet up. I'm going to get him to confess that he is bbigwyres, as he is my top suspect for "#1 audiopile".

Use torture techniques if you have to.

My god, that's what I always hear in my mind when I read/hear "New York City."

@Ken: ha! Cool.

"I have achieved hivemind with Ken. His resistance is futile."

- medic8r of Borg

Somewhat on topic for your thread. My creative heroes talk about drugs.

Here's a great article on the many aspects of patient non-compliance/non-adherence. In layman's terms - why don't people take the medications that are prescribed for them? Also, why do they sometimes too trusting of anything sold at a nutrition store?

Amen, brother. I'm sort of the opposite. I don't trust supplements, but I do trust medications.

I didn't read the article, but I think patient non-compliance relates to pervasive consumerism.

Since individuals rarely have to pay for the full cost of office calls, they tend not to fully comprehend the value of the service. Most people inherently believe that "you get what you pay for" and since they do not perceive that they are paying for the professional advice, they justify ignoring it. Conversely, they DO have to pay "retail" for supplements, so they tend to justify that expenditure as valid.

Personally, I'm pretty much with Ken. If I'm going to engage health care professionals, why would I pay for their knowledge and then ignore it?

The only medication I have ever taken regularly are pills for cholesterol. Actually, my bad fat levels are great but I am low on the good fats, the mono- and poly-unsaturated fats I think. I don't think my Doctor was very impressed with me when she explained this all out to me, sat there waiting for my reply with her usual stern look and then I replied "Whoohoo! More Peanuts!!"

In any case, it took me forever to get into the routine of taking a daily pill. Not because I don't value their worth or I don't value the advice of my doctor, I am simply a horribly forgetful person. Plus, they are supposed to be taken before bed as the body produces the enzymes or something or other that I am low on while you sleep. Quiet often, I stay up too late and I barely make it to the bed, much less remember to take a pill. Now that I am in the routine, it's more second nature but it took me months to become good at it.

Short version, not everybody lacks comprehension. Some of us just suck at breaking routines.

Thanks for this article, JP. My dad is a supplement junky. Whenever I get sick, he asks what type of supplements I'm taking. When I tell him only a multivitamin and an extra Vitamin C, he says, "well, apparently they're not the right ones". I get SO frustrated! In fact, I'm seem him get sick FROM supplements mainly with rashes and stomach problems.

Anyway, here's a funny story. He got sent a supplement in the mail he claimed he didn't order. Well, he previously ordered it and was sent another one on their auto-ship program. When I asked him if they informed him he was going to be enrolled in the program, he said he didn't remember. Then I asked him what the supplement was for, and he said, "I think it's for your memory...but, I don't remember". We both got a good laugh out that one!

I gotta hand it to my dad though...he's almost 82 and has never had any serious health issues. He's still very active, but I don't credit it to supplements.

Sounds like my grandmother. She'll take just about anything or do just about anything that says it'll keep her healthy. Or at least if Dr. Weil says it will.

On the other hand, she's 81 and healthy as a horse, as near as we can tell.

That's a good story!

Supplements can be helpful for some, but they are certainly not cure-alls. There's a lot of snake oil out there.

I don't "trust" any of them. They all have an agenda.

Looks like that mouse in your avatar has been taking steroids, or mouse growth hormone, or creatine, or ...

or.... watching kitty porn?

lol. Are the avitars bigger today? or do I just need new glasses?

They do seem bigger

They're 80x80 pixels, which is the size they've always been. I'm guessing that someone set the software to display at 125% by default or something....assuming that's even possible.

'Cuz they look bigger to me, too... though I'd need a blind A/B to trust that.

Thats easy to set up. Close both eyes and have someone mark A on one and B on the other. Then take turns looking through each eye. Does on seem bigger than the other.

No? Drink two beer and repeat...

Life in a small town mental health clinic is interesting. Today, this message was in my email inbox:

---
Good Afternoon,

Wanted to know if anyone would like to buy some Red Eye Javies these are peas. They are $12.00 a bushel they make the brown juice. Let me know and I will bring them tomorrow.

Thanks,

Tina Xxxxxxxx

Sec II

478-xxx-xxxx

---

Well....are you going to buy them peas or not??

Nah - he's got enough brown juice already.

ewwwwwww

I joined a new message board - it's for residents of Fredericksburg, VA, where I'll be moving (back to) in a couple of weeks. One of the abbreviations used there is FUG for Fredericksburg. I thought the post count-related titles were worthy of mention:

0 FUG Freshman
25 FUG Sophomore
50 FUG Junior
100 FUG Senior
200 FUG Graduate
400 FUG Professional
700 FUG Frequent Flyer
1200 FUG Addict
1600 FUG Honcho
2500 Master FUGer
3000 Super FUG
5000 Mystical FUG Sage
7500 Mega FUG
10000 FUGmaster Flash
25000 FUG Dignitary
30000 Permanent FUG Fixture
50000 FUG For Life
75000 TheFUG

You're seeing another message board on the side? Fug you!

I'm sorry, honey, when I'm posting with her I'm thinking only of you.

Shouldn't 700 be frequent FUGer?

Been busy with the move back to Va and the new job, so I haven't been around as much. What did I miss?

Here's a cool infographic, USA Today style, about what I do for a living. I realize the author is not exactly the biggest fan of me medic8ing everyone - Cam, is that you?! - but I still enjoyed the pretty picture.

BTW, what he fails to mention is that six of the top ten are generic meds now and are dirt cheap. Prozac and Desyrel (trazodone) are $4 a month at WalMart and other big chains.

What did you miss?

Well, there was the free M80 V3 giveaway to people with between 4114 and 4116 posts that expired at 12:00 noon eastern time today, but other than that, not too much.

That's a relief.

Welcome back, JP!

What is also not mentioned is that often these drugs are not nearly as effective as the industry would have you believe, and have more/stronger side effects than reported.

Depression sucks, is still poorly understood and we only have crude tools to deal with it.

Effectiveness really depends on the type/design of study, but I'm no statistician. Overall, I'd say the meds we have are pretty good for the majority of people with depression. They could definitely be better, though, and the pipeline has stalled. There's not been anything really new in about 15 years, just a lot of "me-too" drugs (Company A has a product that sells, and other companies develop other meds in the same family) and minor tweaks on old meds (Now it's extended release! / Now it's the active metabolite, not the parent medicine! / Now it's the active isomer, not the racemic mixture! ....)

Plus, while I make my bread and butter as a Pez dispenser, I'm a big believer in psychotherapy. There is usually at least some psychotherapeutic process at work in my sessions, though I have heard of some psychiatrists who basically ask how the meds are working, if there are any side effects, and how many refills you have left. NEXT! Anyway, when a person is motivated, he/she can learn major, life-altering techniques, perspectives, attitudes, and behaviors with a good psychotherapist. It really is mind over mood, and it works.

Side effects of antidepressants aren't generally that bad, but the new generation of antipsychotics/mood stabilizers can be very rough: weight gain and secondary blood sugar elevations to the point of developing diabetes; increased cholesterol, permanent and irreversible involuntary muscle movements (though the chance is much less than that of the older generations of these meds) ....

Still, for the majority, the benefits outweigh the risks, as not everybody gets side effects, and some meds are much cleaner than others in the same family. However, the cleaner meds are not always as reliable as the meds with more side effects. So it's a mutual decision between the medic8r and the medic8d.

Yeppers-

"That is why it is important, as I said, to understand the process, the ways of our own thinking. Self-knowledge cannot be gathered through anybody, through any book, through any confession, psychology, or psychoanalyst. It has to be found by yourself, because it is your life; and without the widening and deepening of that knowledge of the self, do what you will, alter any outward or inward circumstances, influences - it will ever be a breeding ground of despair, pain, sorrow. To go beyond the self-enclosing activities of the mind, you must understand them; and to understand them is to be aware of action in relationship, relationship to things, to people, and to ideas. In that relationship, which is the mirror, we begin to see ourselves, without any justification or condemnation; and from that wider and deeper knowledge of the ways of our own mind, it is possible to proceed further; then it is possible for the mind to be quiet, to receive that which is real."

Jiddu Krishnamurti.

Shrink!

LOL!

Here's a knowledge throwdown I did by commenting on the death of Harvey Pekar. That coroner either is doing somebody a solid or is very dumb.

You got THE last word on that one, JP.

Lost track of this thread.


True. I am no statistician either. It seems there are a number of more recent studies that suggest medication is less effective than thought by the medical community. It is certainly much less effective than the manufacturers would have you believe.


It works. In fact the one consistent theme in studies on depression is that medication and psychotherapy are much more effective than either on their own.

Depression has many causes and many pathways. I think that it is much like autism, a spectrum of 'disorders'. My depression was situational: who I was married to. My Aunt's was hormonal and took the medical profession a good 40 years to figure out. For others it seems to be how the brain is wired, but even there, the neurological pathways are not always the same.

The most fascinating recent research is around a part of the brain labeled area 25. It seems for a significant portion of people with 'un-treatable' depression. A single treatment of low level electrical stimulation to this part of the brain had immediate, significant, and lasting (somewhere around 4 months) effect. The research was undertaken by a Montreal neuro biologist and a Boston (I think) brain surgeon. The first round was very limited and they are not in their second round now.

Depression sucks. Many treatments are only partially effective, the causes are complicated and it is socially unacceptable. In the recent surveys I have seen, only 30% of people are successfully treated. For the rest any treatment is only partially effective.

Think on this. If an anti-depressant is 60% effective, it is considered a huge success. If you're broken arm is 60% fixed, you are on your way to see your lawyer.

Looking from the outside in we have made large strides in treating depression in the last 50 years. From the inside 40% less depressed is still not anything approaching a good experience.

This is not a slam on your profession JP, just my observation as an insider.

Hey, I just saw your post, Fred. Hadn't stepped into my Axiom Office in a while. You're right, the subjectivity built into my specialty is both a blessing (keeps it interesting and less monotonous) and a curse (means cures are usually elusive - we can only treat).

I came back to post a link to a local Craigslist ad for a 1958 Harman Kardon tube tuner and tube amp. Thought it was interesting and that you guys would appreciate it.

Another fun day at the office. One of my patients just showed up in the lobby (without an appt) with lottery tickets affixed to his forehead. He had wrapped them up with tie-down straps.

Did he win?

He's a winner, that's for sure. So yes.

I went to get a cup of coffee out of the pot in the office kitchen. The pot was empty, so I passed. Now I'm wondering, did I choose not to make more coffee because I'm lazy or because I have a sense of entitlement? Yes, I hear the reply already - "or both?"

Yeah, these are the things I ponder.

Shrink.

Incapable?

Ha. It was funny, the last time I made coffee. One of the nurses was there and felt like she needed to help. The executive director walked in, laughed, and said, "How many advanced degrees does it take to make a pot of coffee?!"

Maybe you need to hire Terry Tate "Office Linebacker"

I know!

I actually thought of him after posting that. If we had him, I'd never have encountered an empty pot.

"YOU KILL THE JOE, YOU MAKE SOME MO'!!!!"

Still my favorite SuperBowl commercial ever.

Sounds like you have a self image problem where you don't want to appear inferior, so you just skipped the task.

You DON'T walk away from an M22 PAPER JAM!

JP changed locations - again - and got a partner.

Nope, nope. I'm pretty sure the one on the left looks like a strict Jungian.

Nice, Tom.

What you can't see is the fine print under "Help" = "script jockey in training".

I though you said your prefence was 'Pez Dispenser?'

I adopted your term just to be friendly. I guess I'm pliant, like Audiosavant's girlfriend.

A new patient this AM summed up her story with, "I need a miracle."

No pressure ...

I know a witch doctor that can help.

What do you prescribe for that?

Was there any blaving?

I looked it up? No result?

To blave, means to bluff. We all know that.

LIAH LIAH LIAH LIAH!

Get back, witch!

I'm not a witch, I'm your wife! And after what I just heard, I'm not even sure I want to be that any more!

Here ya go, Argon.

Wow, I didn't get that at first, and I should be ashamed, even if it was a bit of a tangential reference. The Princess Bride is one of my favorites.

You have no honor.

I roll my eyes in your general direction.

(Thanks, pmbuko)

Awesome. That's what was missing.

All of these silly words that are encroaching upon the English language, really bother me.

Call me a stick and the mud, but it's a societal ill that's penetrated our youth, to the point that their vocabulary is pretty much limited to a social construct of made up words by philistines.

And no, the aforementioned word is not slang! There is a difference!

Where is George Orwell's Newspeak?!

Just to be clear, I'm obviously not referring to you guys as nonintellectual, but rather the large segment of society that has a limited vocabulary consisting of said words.

Rant over........That feels better .

Language is dynamic. Get used to it.

To the point of being bastardized?

Broad statements like that are problematic IMO. I've seen far to many examples where words from the Urban Dictionary have supplanted a proper word. I think language is jeopardized when foolery can sneak in, but most importantly when it stagnates development.

Virtually everything is dynamic, but just because it is, it certainly doesn't justify every change.

Where has the proper word been supplanted, though? On the internet, where speech is typically casual, full of colloquialisms? Sure, I'm annoyed by common grammar mistakes and mis-used words as much as the next guy, but until I see such mistakes and bastardizations in common use in edited material (newspapers, magazines, books, etc), then I'm not too worried. There have been different "classes" in language for as long as there have been functional divisions within societies.

I'll decide what I like on a word-by-word basis. I won't deny myself a new word just because it's new. If I like it, prepare to hear it. Ha ha.

U R rite. I'm down wif u, homey.

U cool, bro. We tight.

[quote=pmbuko but until I see such mistakes and bastardizations in common use in edited material (newspapers, magazines, books, etc), then I'm not too worried. [/quote]

If language IS fluid, then one should be worried all the time. It's being a witness to the changes that makes them hard to bear.

I freaked when impact became a verb.

Now I freak because the comparative is disappearing. It's not crunchier, it's more cruchy. It ain't prettier, it's more pretty.

And I would like to receive a check for punitive damages each time a national news person says "incidences."

Someone in Seattle dies a little each time anybody says "expresso".

But they typically welcome it, because they're already so depressed from all the rain.

Nuthin' like an expresso to wake you up on the morning espress train. Hey, everyone needs some sort of ecscape. If not, people would go nucular, irregardless.

Sorry, I meant irregardlesically. I'm more smart than that!

::Waiting for Ken's head to explode::

Naw, ya'll's doin' it on purpose.

Bob,
You are wrong. It is not "More Pretty" - it is "More Prettier"

So the drug lunch today was for Latuda, a new atypical antipsychotic medication. It's about the tenth medication introduced into that family in the last 15 years. As such, they will need some compelling evidence to get any of us to change our prescribing habits, since there's plenty of variety in the previous 9 medications to address most patient's needs.

Damned if they didn't make a compelling case, e.g. the efficacy of some of the more potent medications mixed with the tolerability of some of the milder ones. Of course, they all look nice and shiny when they're new. We'll see how it goes when the rubber hits the road.

P.S. Roast beef sandwich on a kaiser roll; potato salad, and a chocolate chip cookie. Bottle of water.

Drug rep was a dude. Handsome, but not, you know, Julie Bowen or anything.

Ahh. Just take a few yourself and notice what unusual colors you see.

Would it be overkill for us to get Jennifer Love Hewitt to play The Drug Rep? Probably have to wait for the sequel.

She's in my top ten.

Your funny top ten?

She (Jennifer) is getting a fair spread back there. Personally, Jessica Alba could rep for me.

Really? That's been sitting here for six hours and nuthin.'

How about ten weeks?

Yeah, JLH has been victim of gluteal enlargement syndrome, at least partially caused by her daily breakfast of Coca-Cola. Serously, I remember reading that about her in an article years ago.

I'm posting in this thread again because, after watching a Chuck Jones documentary and a bunch of Looney Tunes cartoons lately, I've come to the realization that PopeBobBeatified, or whatever the hell he calls himself these days, is the reincarnation of Bugs Bunny. Discuss.

Ehhh, what's up (with that), Doc?

That's funny. On a whim, I watched a bunch of Looney Tunes on Sunday.

Excellent observation about Bugs/Bob. Explains quite a lot, really.

I can't watch a Bugs Bunny cartoon now without picturing Bugs with a Bobstache.

I think you're blending Bugs Bunny with Groucho Marx.

Thankfully I don't pre-date the latter, 'cause I'm pretty sure I do pre-date the former.

Bob's more of a Yosemite Sam, imo.

Wasn't one of the Village guys a cowboy?

Hey, Bob, I like your new sig line. But aren't some of the cars in hell made in Italy?

Never mind. I knew I had heard your sig line somewhere. So I found the proverb (or one version of it, at least):

"In Heaven, the cars are German, the banks are Swiss, the police are British, the food is Italian, and the women are French."

"In Hell, the cars are French, the banks are Italian, the police are German, the food is British, and the women are Swiss."

The original had nothing to do with products or services, per se.

The original was about female domestic help.

Something like, "Heaven is an Irish downstairs maid, a French upstairs maid, an Italian cook, German house keeper, etc."

"Hell," naturally, was all the same characters, but with their nationalities switched around.

I only wrote it (Hell is for Pat Benatar and French autos), because, now as St. Bob, I was just let in on that fact. I have become privy to many others, which I may or may not divulge, but only on holy days of obligation.

I adore Letters of Note.

Topically, today's interjection from Kurt Vonnegut:

There is no hell, but since the O.J. Simpson trial there is serious talk of constructing one. It would be modeled after the Atlanta Airport.

The Python's once did a skit where dead celebs were being interviewed with a mike stand in front of their stood-upright coffins. More than 30 years earlier than Kurt.

I have a theory. People who drink less water are smarter and more likely to fall in love.

Doc, care to take a stab at why I propose this?

I'm not a doc but here is my theory.

- In my younger days I tended to drink the most water when I was hung over.
- If am hung over, I was drinking the night before.
- If I was drinking the night before, I was more likely to have been "socializing" with women.
- If I was socializing with women, I was more likely to have started a relationship.
- If I was trapped into started a relationship, I couldn't go out drinking with the boys as much anymore.
- If I couldn't go out drinking with the boys anymore, I was meeting less women.
- If I was meeting less women, I'd be more likely to be saying the "L" word in a desperate attempt to justify to myself why I wasn't going out with the boys anymore.
- If I was saying the "L" word more, I was, in turn, being taken advantage of more.
- If I was being taken advantage of, I'd soon realize this was never "love" and I'd escape the dying relationship.
- If I wasn't in a relationship, I'd go back to going out drinking with the boys and then drinking more water.

And thus the cycle continues.....

So water is not to blame, it is simply a byproduct of the cresting wave before one enters into a period of falling in love.

Edit:
To point out the cycle can be broken....
When I met my wife, it was indeed in a bar. However, she actually enjoyed hanging out with my buddies and soon became an accepted and natural part of that crowd instead of becoming what was once a choice, girlfriend or buddies. Married that girl and yes some friends have changed and I certainly don't party like I used to, but neither do my friends.

You can beat the cycle!!!!

Quit stealing my answers!

Nicely done, Murph.

I'm curious as to where Chris is going with this.

My first wild thought is that people who drink less water often, as a result, are hungrier and eat more carbohydrates in particular. If, then, more glucose gets to the brain, then it has more fuel and could, in theory, get more done/be smarter.

Also, if a person is getting dopaminergic activation from sugar highs, he might be more inclined to pursue other activities that cause a similar good feeling, such as sports, hobbies, message boards, and romance.

I'm so totally sure that's it.

Now I feel bad, since so much thought when into those replies, and my theory is based on a simple idea.

People who drink less water cause their bodies to release arginine vasopressin (AVP), an anti-diuretic. AVP also has been implicated in memory formation, and is being investigated as a nootropic (thus the core of my theory). It may or may not apply to humans, but at least in voles, AVP seems to affect reward circuits during partner selection.

I came across this because I'm interested in nootropics, and one of my favorite authors had a character who abused vasopressin.

Well, at least he's not abusing Viagra.

...which would make him colorblind.

Vole sex is hot.

S'bout time.

I'm over it.

Knew it.

Jessica Alba plays a horny drug rep in "Little Fokkers". That is all.

I may have to see that one.

So there's a new antidepressant out, which is always kind of exciting. The antidepressant pipeline has been kind of dry for the last decade.

However, my initial impression after a bit of research is that, as is often the case, this new medicine will be an expensive way to get approximately the same effect that you can get with currently available generic medications.

The brand name of the new medication is ViiBRYD. Aren't the cutesy double lower case "i"s about enough to make you barf? The scientific/generic name is vilazodone, which at once made me think of trazodone (Desyrel) and nefazodone (Serzone), antidepessants from the 1980s. Indeed, vilazodone is a piperazine-class compound, just like trazodone, nefazodone, and a whole host of other medications.

The drug rep proposed that ViiBRYD works like a combination of Lexapro and Abilify, because it inhibits serotonin intake, like Lexapro and the other SSRIs (selective serotonin reuptake inhibitors) and is a partial agonist of the serotonin 1-A receptor (like Abilify). Thus, a patient can avoid the currently in vogue regimen of adding an atypical antipsychotic (Abilify, Seroquel) to his antidepressant, getting similar effects in one pill instead of two. Fewer copays, etc.

Wow! Sounds good! Those are some powerful meds you're emulating, alright! Sign me up and let me hand out these samples to all of my depressed patients!

Wait. What the drug rep didn't mention is that Abilify is actually much more than just a serotonin 1-A partial agonist. Its activity there doesn't even account for the majority of its therapeutic effect, which is from its effect on dopamine, where it is also a partial agonist. All in all, Abilify is active in almost a dozen ways - I call it my Swiss Army knife: good for almost anything.

A more accurate analogy would be to say that ViiBRYD is like a combination of Lexapro (or your SSRI of choice) and buspirone (BuSpar). Buspirone is a 1980s era molecule which had modest success treating generalized anxiety before going generic in 2001. About all it does chemically is through that serotonin 1-A receptor, so it was billed as having virtually no side effects. Of course, many patients also said it had virtually no good effects, either, but often they had seen the big guns of benzodiazepines (Xanax, Valium, Klonopin, etc) and, by that point, addressing their anxiety with buspirone was like addressing a bear with a slingshot. Now, for benzodiazepine-naive patients, buspirone was pretty decent. But I digress.

Anyway, on the $4 list at WalMart, Target, and several other pharmacies, one can find not only buspirone but several decent SSRIs such as fluoxetine (Prozac), paroxetine (Paxil), and citalopram (Celexa). I like citalopram due to its good overall tolerability. It was the precursor to Lexapro, anyway, with the same active ingredient; Forest Pharmaceuticals just played some isomer games to create Lexapro. So citalopram + buspirone = SSRI effect plus serotonin 1-A effect for $8. I don't have cost info for ViiBRYD, but most branded antidepressants are ~$200 a month. Even with insurance, you'll probably have a tier 3 copay, if it is even covered in the first place.

So I don't think I'll be writing a lot of ViiBRYD. But it was nice of them to remind me of some of the pharmacologic principles at work so that I could save my patients, and the health care system, some money.

Trazedone can cause Viagraitis. Careful.

I'm not a big "done" fan myself. Thanks for the heads-up, so I will know what NOT to demand!

Yeah, the risk of priapism with trazodone is about 1:7,000. No such luck with busiprone or the SSRIs, though.

J.P., whenever I hear or read anything about antidepressants, I always think of the word "tricyclic", for obvious reasons, but mainly because I just think it's a neat word.

Now I'm depressed.


I'm just glad I don't have to take any of them. But I was taking lisinopryl for years, then I started to caugh. Not real bad, but just enough to be worrisome. I discovered it was a side effect of lisinopryl when taken over several years. My doctor switched me to Avapro which was going to cost me $60 a month co-pay. My doctor also gave me some info on (I forget the name) program that allows me to pay just $20 instead of $60 as long as I'm not receiving any government assistance money in any other programs.

Right on. Interestingly, the conventional wisdom is that the tricyclic antidepressants of the 1960s and 1970s are just as effective, or maybe even slightly more effective, than the newer generation SSRIs and SNRIs. The main reasons that the newer generation supplanted them are (1) better overall tolerability and (2) next to zero chance of lethality in overdose.


My guess is that it's a program set up directly by the manufacturer of the medication. Lots of companies have them. They'll give you a break on the copay since they still get your $20 plus whatever your health insurance company paid them. Later, if you like the med and choose to stay on it, you pay the full copay, and then things are really looking good for the company. Like the corner drug dealer, the first one's free, or in this case, heavily discounted.

This option lasts until Dec 31, then I was told I can re-apply to have it renewed and it will be renewed as long as I don't have any other kind of government benefits.

Woody Allen is jealous of dermatologists, because they get to say beautiful-sounding words, like hairy leukoplakia.

[quote=medic8rRight on. Interestingly, the conventional wisdom is that the tricyclic antidepressants of the 1960s and 1970s are just as effective, or maybe even slightly more effective, than the newer generation SSRIs and SNRIs. The main reasons that the newer generation supplanted them are (1) better overall tolerability and (2) next to zero chance of lethality in overdose. [/quote]

How much $$ was shelled out in grants for us to learn this? I want half! 'cause all they had ta do is call me, don't be afraid, they can call me, maybe it's late, but just call me.....

Gee, I hope velevet hammers make a come back.

Now thats interesting. Unfortunately, the general effectiveness of antidepressants is much lower than drug companies would like you to believe. It shows how little we really know about how the brain works (or doesn't). I'm just glad I don't need those things any more. Depression is hell on earth...

Then you're not taking enough.