The boring life of Jerod Poore, Crazymeds' Chief Citizen Medical Expert.

1/2-to-2/3 of the Way to Oblivion

As my 50th birthday approaches I reflect upon what I probably never will do, as well as some of the great birthdays I've had in the past.

First up, things I've started, but will never finish.  I began most of these between the late 1980s and mid 1990s, and have been working on them sporadically ever since.
  • Several books and a couple of screenplays
  • Encryption software for social media
  • Learning Japanese
  • Numerous articles for Crazy Meds (since 2004)
Things I'd like to do before I die (the ever-trite bucket list).  I'm as likely to do any of these as I am finishing any of the above projects:
  • Visit the Grand Canyon, preferably off-season and after the air has been cleared by a good storm.
  • While I'm in the neighborhood, see the Arizona Meteor Crater.
  • Live somewhere between 53° and 60° north latitude for at least two years.  I'd also like to be at least 3,000 feet above sea level and have a clear view to the horizon facing north, east, or west.  A completely unobstructed northern view would be difficult, but east or west is certainly possible.  As it's never going to happen I may as well dream about living on a fucking Scandinavian mountain top.
  • There were more, but since I read this article in The Atlantic, I'm not caring all that much about, well, anything.  I go into too much detail about it all on my Crazy Meds-based health blog.
Like Thanksgiving, Christmas, etc. my birthday is just another day to me.  Unlike Christmas and some other holidays, the TV schedule is rarely different, which is the only thing that distinguishes a holiday from a non-holiday to me now.  As my birthday is during the President's Day three-day weekend more often than not (especially since so many people tend to stretch those out to anything from 3.5 to 6 days), and is less than a week after National Disappointment and Heartbreak Valentine's Day, it is easy to overlook.  Unless God/fate/karma/the universe has nothing better to do:
  • I'm a true child of the Space Age, as I was born the day John Glenn made his historic space flight.  My mother isn't exaggerating all that much when she says I popped out the same time he emerged from his capsule.  As a kid I built lots of shitty model rockets.
  • 1976 - The one time it snows in Stockton during the entire time I lived there is on my birthday.  When I'm sick.
  • 1980 - The tradition of the birthday nervous breakdown begins.  It takes me about two years to fully recover from this one.
  • Before we get married, my (now ex) wife moved in to my apartment.  At some point after that (this happened about 30 years ago) her former roommate's boyfriend moved in with the former roommate.  Said boyfriend was an abusive douchebag and I spent my birthday supervising his eviction and helping to prevent the former roommate from changing her mind.  While those activities were essentially positive, learning about what had been happening was the suckass part.
  • 1986 - Second nervous breakdown begins.  It started a week or so before my birthday, but close enough.  I'm over this one in a little over a year.
  • 1989 - Saw Laibach at the SF I-Beam.  They didn't get on stage until long after midnight, and were drunk as fuck when they did.  I smuggled in a tape recorder, which managed to not record anything.
  • 1999 - Three days after being hit by a car, it's pretty obvious that one of the cats isn't going to recover.
  • 2002 - Most recent, and worst of all birthday breakdowns.  I have yet to fully recover from this one, and I don't know if I ever will.
  • I've spent a lot of birthdays in hospital waiting rooms and doctors' offices.  Sometimes driving for hours to get to specialists.  I wasn't always the patient.
  • 2005 - Hunter S. Thompson dies, Robot Chicken premieres.  I have no idea how to rate this one.
 I had more, but these things just don't seem all that important now.

    We seem to be up and running

    I've yet to get a message from tech support.  Everything is running OK, and it looks like they finished around 2:00 AM (Mountain time) Friday morning, but I'm still getting some odd messages in the system log.  I'll check in with them Monday.

    Make That Friday for the Scheduled Downtime

    Lunarpages tech support called me when I was on my way out getting groceries.  There's some sort of law covering that, isn't there?  

    In any event the down time is now scheduled for tomorrow.  That's Friday, 13 January at 5:00 PM Pacific Time, 6:00 PM Mountain, 0100 Saturday GMT.

    -------------------

    It looks like the disk-drive replacement started last night around 7:00 PM Pacific, 8:00 Mountain, 0300 GMT.

    So far the site is still available. Parts of the OS are acting oddly, so don't be surprised if the forum or wiki software acts strangely, or any posts made between then and some other time vanish, etc.

    More Scheduled Downtime - As in Sometime Today

    The techs at Lunarpages are seeing another RAID drive failing and need to replace it today.  As soon as I know when that will happen I'll post it

    This will affect the entire site - forum, drug pages, and PI sheets.  It will take as long as it takes, because it depends on a bunch of factors, like what happens to be on the drive that is failing.

    ---------------
    Update 1:25 PM Mountain Time (20:35 GMT) 

    I haven't received word as to when this is going to happen.  I really need to get some groceries, as I'm pretty much down to earthquake supplies.  I'd also like to see if the pharmacy has the rest of my methylphenidate prescription.  So don't be surprised if we're suddenly gone, or if everything is running smoothly until sometime after 10:00 PM Pacific Time tonight (0600 Friday morning GMT).

    More Scheduled Downtime

    Tech support at the domain host need to tweak the replaced disk array a little bit.  We scheduled Tuesday, 10:00 AM Mountain time (1700 GMT) for that to happen.  They expect it to take no longer than 15-20 minutes.  As it involves hardware the entire site will be off the air.

    We're back up, but who knows what things are going to be like.

    Well, wasn't that special. When I restored everything to Sunday night's backup it turned everything back online. Which makes sense, because that was the status at the time of the backup.

    I hope it everything works. Especially since I was restoring the fucking database, then converting it to a new format.

    And Now We're Gone Once More

    And the forum is offline again, because way too much is broken.  Looks like I need to rerun the install.  We may lose whatever was posted between midnight Sunday and now.

    ------
    OK, I'm testing the board software.  Smilies are fucked-up.  Not that I care.

    And all posts, PMs, blog entries, etc. that happened after midnight Sunday are gone.  Sorry.

    We're Sorta Back

    The good news: the forum is back online.

    The bad news: the blogs aren't.

    I'll try again tomorrow with the blogs, although it may require tech support, which means Tuesday at the earliest.

    I haven't tested everything, so I have no idea what works, what doesn't, what has and hasn't been fixed or broken.  Guess we'll all find out together.

    Forum Software Upgrade has Begun

    I don't expect this to take too long, as in two hours or so.  We'll see.  Check in around 2:00 PM Mountain time (2100 GMT).

    ---------

    OK, make that 3:00 PM Mountain time (2200 GMT).  I thought I had already uploaded the software to a holding directory on the server.  I didn't.  Hence the extra hour.

    --------
    This is what I get for writing an optimistic target time.  Apparently the tag conversion process takes a long time.  The more tags (over 1,100) and more blog entries (nearly 4,000) there are the longer it takes.  So this could go on for quite some time.

    Reminder: Forum Software Upgrade

    I still plan on updating the forum software tomorrow.  Beginning whenever I finish amusing the cats, eating breakfast, and finishing the crossword puzzle.  So, figure noonish Mountain Time (1900, or thereabouts, GMT).  I expect to be finished within a couple hours.  Give or take.

    For everyone else who shares my "It's just another day with an anomalous TV schedule" attitude, the only Xmas songs you'll ever need:


    And We're Back

    It took until around 1:00 AM Mountain Time (0800 GMT) to finish rebuilding the array and repair the forum's database.  It's up and running now.

    This is why I love Lunarpages.  I know from my experience back in the Big Iron Age that resynchronizing the data on a RAID after a hardware fault and rebuilding a large database can happen only so fast, but there was someone there until midnight Pacific time making sure it happened.

    We're off the air again.

    Of course I don't check the site before doing anything, so I was unaware that we were getting an internal server error all over the place.  I'll keep everyone posted.

    ----------

    Update 14:41 Mountain Time (21:41 GMT): There's a hardware fault, and Lunar Pages tech support is looking at it.  

    In a way this is partially mostly my fault, as I had seen messages relating to the fault in one of the RAID drives starting a few days ago, but my social anxiety/avoidance was so fucking bad I couldn't even open a ticket about it.  I kept trying to, but just couldn't.

    ----------
    Update 16:45 Mountain Time (23:45 GMT): The drug pages, etc. are back up.  The forum is still down, this time it's unhappy about the database.  The new components of the RAID are still being synchronized, and nothing is obvious when looking at the database, so it might be a matter of waiting.
    The Lunar Pages techs had the hardware replaced in about one hour.  Pretty damn good for the Friday before Xmas. 

    --------------
    For anyone who is wondering and speaks *nix, here are the messages I was getting with increasing frequency for the last week:

    Dec 22 16:17:02 server smartd[18984]: Device: /dev/sda, not capable of SMART self-check
    Dec 22 16:17:02 server smartd[18984]: Device: /dev/sda, failed to read SMART Attribute Data

    That's why I wrote it was my fucking fault this happened.
    -------------

    Slight Redesign

    With all the traffic coming in from Crazy Meds itself, I figured I should change the focus of the blogrolls to something more in line with the Crazy Meds site.  Hence all the pharmacology, brain, and assorted medical blogs are now first, followed by links to similarly-themed sites that aren't blogs, then emergency room/department blogs, then the panoply, other blogrolls, and links to other sites.  I also added a shitload of blogs to the neuro-pharma-med roll.

    There is also another Facebook page, just for site content and status updates.

    I should have known better

    Just because I'm less susceptible to mood swings doesn't mean they won't happen.  I wind up getting depressed and being unable to deal with my life.  Oh well.  It's been over couple years since I was last depressed, and that's the longest since I've been on meds.  As part of distracting myself and convincing myself that I'm doing something I did a huge reorg of the blogrolls.  I've pruned dead links, moved defunct blogs, added a shitload of new blogs to the Panoply, and added a new section dedicated to Emergency Rooms/Departments.  Now you don't have to just take my word for it, you really don't want to go to the ER unless you absolutely must need to.

    Who knows when I'll do all the stuff that needs to be done.

    With Whom Does One Talk About Total Social Avoidance?

    How bad has my social anxiety/phobia/avoidance been?  By the time I've written and addressed 3-to-5 Christmas cards I'm emotionally exhausted, so that appears to be my daily limit.  I'll be lucky to get all of them sent by the end of this week.  The mailman just stopped by to drop off a package.  That's the sort of thing that throws off my entire day.
    Answering e-mail is out of the question.  Posting this on my Crazy Meds blog or the Crazy Meds facebook page isn't happening either, as too many people would see it.

    Like a lot of people I want more, because I can never get enough of what I already have.  I want more latitude, altitude, and solitude.  Living at 47° north has been good for me.  16 hours of daylight with long dawns and dusks in the summer, and 8 hours in the winter with the sunlight filtered by trees most of the day has made me less susceptible to seasonal mood swings.  I'd like to live further north and higher up to enjoy things like auroae and noctilucent clouds more often.  I'd really like a place at or above 53° north and 3,500 feet up, with a clear view of either the eastern or western horizon.  Someplace to set up a telescope to look at anything interesting that comes by, like another green comet, and a receiver to listen to the solar wind.

    As if any of that will ever happen.  

    If I manage to get the resources to leave this lemon of a glorified Unabomber shack I have to use them to move closer to a city with better doctors.  It's becoming more difficult for me to drive, cook, and generally deal with my life.  I need to live where I can take a cab to wherever I need to go, and get food delivered that's safe for me to eat.  Solitude is no longer an option.  Which sucks, because one of the few good things about this place is its location.  Depending on where you center it, the population density here is between 1 and 5 people per square mile.  When I lived in Berkeley and Missoula I often felt lonely.  Out here I rarely do, and when I do it's not as bad.

    I'm Popular! Why?

    Anyone who knows me knows I'm a total stats whore.  Whenever I'm feeling a bit off I look at statistics.  Mainly Crazy Meds' traffic.  
    Starting 28 November there was a spike in the number of visitors.  That happens.  For some reason on 8 November the whole world did a search on Lexapro.  Traffic has been continuously high since 28 Nov. - 10k-12k visitors a day.  Not that I'm complaining.  So I dug down to find out why.  A big chunk of that is due to people visiting the page on TCAs.  Directly.  Not from other sites, not from search engines, not even from clicking on an link in an e-mail, but from pasting the URL into their browser from another source.  The peak was 9 & 10 December, when over 3,400 people stopped by to look at that page.  On 8 December 1,700 people went there directly, on 7 December 900 did.

    The thing is, they stay on the page for ten seconds, if that.  Hardly anyone goes to another page.

    What the fuck is the attraction?

    Most of the visitors are from major North American cities, but plenty of them are from Paris, Sydney, Dubai, Hyderabad and so forth.  Of the places with more than 20 visitors, the people of Istanbul read the most on the site (78 visitors averaging 2.18 pages), and the people of Valencia stayed stayed the longest (39 visitors, average visit 3:54).  Contrast that with the 12 cities where the average time for their 21 to 30 visitors was so short it couldn't be measured - they must have serious connectivity problems in Spokane, Duluth, and Puyallup - and obviously didn't go to any other pages.

    Some of you may understand how I can read so many studies without my eyes glazing over.  I may have lost the math to fully understand the more complicated stats, but I still like looking at the raw data.

    They aren't printing the page.  At least they aren't using the print function from AddThis.  Have I done someone's homework, or is there something hilarious that I'm missing?  Because I don't care how ridiculously stupid something I wrote looks.  As long as the information isn't wrong and it helps people understand and/or remember something they otherwise wouldn't, I'll be happy to duplicate it elsewhere.

    At some point the interest will probably die off, although site traffic overall is still over 9K on weekdays without the TCA page.

    Abilify Page, Updates, More Cites, and I'm Sure it's Just a Coincidence

    At long last, a brand new med page.  Abilify.  It may not be a new med, but at least it's a med that's being advertised.  I'm still working on various pages, but the Basic Overview Page is mostly done.

    I've finally added links to sites with consumer reviews.  Most of the ratings/reviews are from the Big Five rating sites:  Ask a patient   Revolution Health   Patients like me   WebMD   Drugs.com 
    I have links for these meds: 

    Crazy Meds was mentioned in another journal back in February, although it's in an article I'd file under "blame teh InterWebs.". From Psychotropics Without Borders: Ethics and Legal Implications of Internet-Based Access to Psychiatric Medications
    Internet-based consumers have access to extensive medication information through websites such as erowid.com, crazymeds.com, and drugs.com, among many others.
    That is one broad spectrum. 

    We also turned up as a source here, but it was one of those incidents when we seemed to be the only place someone could find the MADRS at the time.  It wasn't the first time we were the only available source for one of the psych tests. 

    In a Zyprexa vs. Abilify study I found I learned that "which sucks less" has an official name - "time to all-cause discontinuation" - and that they run trials just to measure that. Whichever med has a longer time to all-cause discontinuation is the one that sucks less.
    What's funny is when you run a search on PubMed and Google Scholar, the terms "all-cause discontinuation" and "all-cause medication discontinuation" are used in papers exclusively about psychiatric medications, and that comparative studies about how long people stay meds based upon which sucks less don't start appearing until 2005. Prior to then the term appears in a single paper about beta blockers and heart attacks, and then it was just to indicate that all the reasons for discontinuing are all lumped together.
    It has to be just a coincidence that researchers didn't start doing studies comparing psych meds - using the fancy new term or not - to find out nothing more than which one sucked less (or the least) until over a year after I started a somewhat popular site about psych meds that used data from published studies, along with anecdotal evidence I collected and consumer ratings & reviews, to determine which ones sucks less than others.

    Brand vs. Generic page. Finally.

    At long last the Brand vs. Generic meds page has been renovated and updated. 
    As I come across them, I'll add URLs for case reports, studies, etc. that support one side of the issue or the other.

    We're in PubMed, Bitches!

    Of course the journal is Journal of Medical Internet Research and the article is mostly about consumers bitching about side effects online, but, hey, there we are, going head-to-head with WebMD once again.

    Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet

    Crazy Meds and Ask a Patient vs. WebMD and former consumer-generated media site Revolution Health on the effects of Lexapro and Seroquel. The results:
    Consumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information.
    The data are clear: WebMD can suck it.

    The paper raises two points I constantly reiterate:
    1 - Consumer-oriented sites, including this forum, skew negative, which is why I don't depend solely on them for the anecdotal evidence I use in my drug pages.
    2 - Like drug company-sponsored studies, drug company-sponsored professionally-run sites tend to  skew positive, which is one reason why I think they are still useful.

    You have to really read the article to realize Crazy Meds and Ask a Patient are not total bitchfests about meds, especially since significantly more people taking each med reported they worked better on the consumer-oriented sites than on the professionally-run sites.  I may have to re-evaluate how the stats skew.

    Oh, NOW You're Crazy

    Brent Arthur Wilson decided that he's crazy after all.  The Montana Supreme Court disagreed.  From the Missoulian:
    Brent Arthur Wilson, who insisted on serving as his own lawyer dozens of times during court appearances last year and once threatened to "arrest (the) bond and seize (the) surety" of any attorney who said one word on his behalf, argued on appeal that he never should have been allowed to represent himself.
    The court disagreed, and also ruled against Wilson on two other issues.
    "Though we acknowledge that Wilson's demeanor with the District Court was unconventional and at times somewhat bizarre, the fact remains that he was found by a mental health evaluator to be mentally capable of making decisions and fit to proceed and act on his own behalf," Justice Patricia Cotter wrote in the decision.
    "Mindful of Wilson's right to represent himself if capable of doing so, the District Court was placed in the difficult position of balancing Wilson's constitutional right to counsel with his right to represent himself," she went on. "We conclude the District Court did everything in its power to persuade Wilson to accept counsel, without unduly pressuring him to do so in possible violation of his right to represent himself."
    Plus there was this bit during his trial:
    "For the record, on the record, let the record show I have no constitutional rights, I want no constitutional rights, I claim no constitutional rights," Wilson said repeatedly during court proceedings.
    Be careful of what you wish for and all of that.

    Mug Discount & New Bumper Stickers

    Zazzle is offering a 30% discount on mugs today (10 November) only, until 11:59 pm Pacific time. In honor of Veterans' Day, which is tomorrow. Enter code:
    VETERANSALE4
    at checkout in the "Zazzle Coupons/Gift Certificates" box. More details here.
    Crazy Meds mugs are here. You're welcome for all the notice.

    I've also put up a bunch of new bumper stickers, which you may or may not be able to see when you read this.  A whole bunch of Team stickers: Agoraphobia / Anxiety / Bipolar /  Crazy / Depression / Epilepsy / Manic! / OCD OCD OCD OCD / Panic! / PTSD / Schizophrenia.  As well as: I Feel Fantastic!, My Doctor Can Beat Up Your Doctor, and My Shrink Can Beat Up Your Shrink.  All of which are available as mugs and t-shirts.
    Also new is a Team Crazy Meds mug, which I've also done with a solid black background.  But it's not a completely black mug.  Let me know what you think.

    I got a My Shrink Can Beat Up Your Shrink and a Medicine Is The Best Medicine mug for my doctor.  I'm impressed by Zazzle's print quality.  The imprints on the pills are really clear.  I have no idea how well they will hold up to dishwashers, microwaving, etc.  But fresh out of the box the 'art work' looks really sharp.

    Crazy Meds Mugs & Bumper Stickers Now Available

    The annex to Straitjacket T-shirts is now open at Zazzle.  Right now it's all mugs and bumper stickers.  Some have the same designs you'll find on shirts, and some designs that may show up on shirts eventually, and some have their own designs. 
    A few examples manage to not look like utter crap as they scroll by:



    So get your favorite medication prescriber a gift to show your appreciation, and let them know that someone besides their local pharm reps is thinking about them.

    As much as I've complained about Cafe Press' gods-awful interface, Zazzle's is just as confusing, frustrating, and time consuming, albeit in different ways, such as being really fucking obstinate about orienting the mugs. I either want the handle on the left or in the back. Notice how many handles are on the right. And it handles alphabetical order as well as I did in 2003.

    Plus at $14 for their least expensive mug, or $1 more than the cheapest t-shirt I offer on Cafe Press, I may wind up splitting the merchandise between the two shops or something.  Fuck if I know.  It's going to be a big pain in the ass no matter what I do, so figuring out which option sucks less is going to take time.

    Occupy Big Pharma - or at least wear a t-shirt to tell other people to do so.

    New Shirts at Straitjacket T-Shirts:

    Occupy Big Pharma
    Occupy Big Pharma
    Big Pharma puts profits before people. Let everyone know you want to do something about it. Or at least tell people what you think they should do about it.
    Fuck Big Pharma!
    Fuck Big Pharma!
    If Big Pharma really pisses you off, let everyone know about it.
    Big Pharma Sucks!
    Big Pharma Sucks!
    Or you can wear one of these if "F#¢< Big Pharma!" isn't really your style.
    Occupy Sanity
    Occupy Sanity
    It's political AND a cry for help.




    Team Crazymeds
    Team Crazymeds
    And I want you to be able to advertise my site in as many ways as I can think of. 
     
    I've just opened a store on Zazzle for non-shirt items like mugs and bumper stickers.  I'm working on those.  I'll probably move the shirts there eventually.