Connections Puzzle #918
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Had to work my way back around

Connections Puzzle #917
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Still not tired of the term “rainbow herring!”

I think you need a line break after the second spoiler and I think you are missing a space after the :::

Wait lemme check:

Apparently a hospital in my network is trialing a tool to generate assessment flowsheets based on an audio recording of a nurse talking aloud while doing a head to toe assessment. So if they say, you’ve got a little swelling in your legs it’ll mark down bilateral edema under the peripheral vascular section. You have to review before submitting but it seems nice.

Is it still made by a human if they use the stroke smoothing, clone healing, or edge detection tools in photoshop or gimp? Where’s your exact line?

True art

Maybe I’m being pessimistic but I’m pretty sure the immigration paperwork is gonna ask “has he been convicted of a crime” and not “has he been convicted of a real crime?”

Honestly the research on exactly why this happens is sparse enough as it is. It’s basically impossible to do truly conclusive studies with tobacco because of how dangerous it is. We can’t even technically conclusively say that tobacco causes cancer because to truly scientifically assert that you’d have to do a randomized controlled trial.

To have a truly randomized controlled trial you would have to randomly select people from the overall sample and tell them to start smoking for the purposes of the study (otherwise you can’t technically rule out there being some third thing that both causes the cancer and causes people to want to smoke). And because we know tobacco is insanely addictive and are all but that one millimeter short of proving that it causes cancer, no medical ethics oversight body would ever allow a study that requires participants to start smoking.

Hubs wanted to sell some used household goods but everybody is on Facebook marketplace and using venmo and cashapp and shit these days and I’m just like :| And now his friend says he wants to use zelle for me to go halvsies with him on hubs Christmas present. Fucking marks of the beast!

I won’t say my grammar is perfect, but I do try not to misspell things and insult other people’s intelligence at the same time.

Eh I’m a borderline in a relationship with a bipolar. We could never bring kids into this but tbh neither of us should probably be having kids even with other partners and it’s nice to have somebody who gets it.

They’ll happily take my nursing degree but I’m not leaving without hubs and he has an old weed-related charge that would probably impair immigration to another country.

Honestly I feel the same about buspar but some people swear by it. I actually liked the wellbutrin a LOT it just also gave me terrible air hunger. I’ve wondered if the Dextromethorphan would counteract that.

Lexidrugs (my employer’s pharmacy reference database) only references dyspnea (shortness of breath) specifically for wellbutrin with an incidence of ≥1%. Given that my air hunger never correlated to any outwardly observable signs other than mild tachycardia (no O2 changes), it’s safe to conclude the sensation was neuropsychiatric in origin / somatic anxiety. Both entries do also list the following incidences of adverse reactions relevant to anxiety:

Wellbutrin (bupropion alone):

• Agitation - 2-32%
• Anxiety - 3-8%
• Akathisia - 2% (I’m particularly sensitive to this side effect)
• “jitteriness” - 3%
• nervousness 4-5%

Auvelity (bupropion + Dextromethorphan):

• Anxiety 4%

Now, Auvelity also has a much shorter list overall likely due to it being a much newer and therefore less studied medication. That said I’m seeing a much higher incidence of things like drowsiness with Auvelity (7%) vs Wellbutrin (2-3%). That suggests that the dextromethorphan IS offsetting the stimulating effect of the Bupropion. The question is whether it’ll hit me as a smooth buzz or a delirious haze. Given that the bupropion did improve my attention even with the air hunger I would hope it would be the former but I think I’d want to take a few weeks of vacation to see. Maybe next year.

OH also: did you take wellbutrin or zyban? Brand name zyban was much more expensive than wellbutrin due to “officially” being approved for nicotine cessation. Although if it was super recent probably not because everybody just started giving their smoker patients wellbutrin off-label, which is one of a few ways doctors can just flip big pharma the bird, lol.

Bupropion + Dextromethorphan actually hit the market specifically for depression recently.

could be SSRIs

Honestly an AI use I’m kinda OK with is that it’s making audio transcription services good enough that nurses can start using them and they auto generate a flowsheet for the qualitative data from spoken word (you’d review before submitting) and tbh if I could get back to providing actual patient care instead of filling in spreadsheets that would be cool.

It also paralyzes your cilia so it’s not improbable (cilia are the little hairs that line your breathey tubes and rhythmically beat to push gunk up and out). It’s actually why the smokers cough usually gets worse a few days after quitting then stays worse until you’re finished hacking up all the built up tar. Your cilia wake up to your respiratory tract fucking trashed like WHAT THE FUCK IS THIS.

My first thought when I saw this was damn this is freaky and they haven’t even brought in the third sister yet…

I’m still on the lamictal I figured I should give it a fair shot and like I said I don’t feel like it does anything but it’s not hurting me and the doctor keeps prescribing it. I also currently take a low dose seroquel as a sleep aid. More importantly the one chemical imbalance I definitely do have is ADHD, for which I take clonidine at bedtime and strattera when I wake up. I also take a variety of supplements, in particular magnesium for mood / sleep and NAC for dermatillomania.

Interestingly I’ve heard Japan called “the land of the rising sun” due to being one of the farthest east on the Mercator projection which despite its few features and many flaws is often considered the standard of map projections.