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Today’s ADHD medication discovery

Dextroamphetamine on its own has been working pretty well for me for the last few days, and my blood pressure has been only slightly elevated (not to the point that I could feel it).

Today I decided to try using a small amount of cannabis as well, and within half an hour I felt my blood pressure spike. It’s “only” 140/90, which is pretty elevated and enough for me to feel it, but not enough to worry about.

Anyway, I looked it up and there have indeed been a couple studies that have found that THC and dextroamphetamine interact to cause a blood pressure spike. Oops.

I don’t remember which particular strain I had loaded up in my vaporizer; it’s either Harlequin (which is 95% CBD) or Lemon Smac (which is 100% THC). So I’ll need to try a more careful experiment in the future to make sure I’m even using the right strain to begin with, but I don’t think I’ll be doing that any time soon. I’ll also probably want to try it with something that’s nearly 100% CBD just to be relatively-safe.

Fenofibrate

Fenofibrate is affecting me the same awful way that Lipitor did, back in the day. If triglycerides are the problem underlying my pain, this medication doesn’t seem to be the answer.

Maybe I should try just eating nothing but salad for a month.

Dextroamphetamine, day 1

I took my little 10mg capsule when I woke up at 8 AM, and I felt it kick in during my shower. It’s led to a feeling of clarity and less chaos in my brain. I did a few put-off chores before work, and at work I’m not feeling totally overwhelmed by stuff. I’m still not focusing on what I mean to be working on, though.

Blood pressure is 131/89, heart rate is 65. Slightly elevated from my baseline but definitely nothing to be worried about. My hands are also slightly shakier than usual but not, like, alarmingly so.

This shows some promise and I’ll be working to adjust the dosage and timing accordingly. I might try supplementing with a caffeine microdose later today.

Also, last night was my first dose of fenofibrate, which hasn’t solved all my pain issues overnight but I’d expect that to take a week or so to be effective.

Twitter alternatives

Because of Twitter’s impending buyout a lot of people are talking about alternatives to Twitter, including Mastodon. I could write a bunch of long rambles about this, but I already have:

Basically, my problem with Twitter isn’t that it’s centralized, but that it’s Twitter.

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Pain, fatigue, and focus

Two weeks since my last ketamine infusion and my anxiety is… present, again, and my chronic pain never went away at all but now I’m feeling a lot more aware of it.

I went back and tried Adderall again and it didn’t mess me up, although it also didn’t help me like it did the last time I tried it. But neither Adderall nor caffeine are messing with my blood pressure or increasing my anxiety, so I’ve reopened the conversation with my doctor regarding other meds for ADHD. In particular, I asked about Dexedrine and Desoxyn. Both of them seem promising at the dosages I’m looking at, although my insurance won’t cover Desoxyn (which is unsurprising, there was a TV series about it) so we’re trying Dexedrine first.

Regarding chronic pain, my doctor went over my chart and he noticed that we never really did anything about my high triglycerides, and then he had a thought: what if my high triglycerides are contributing to my fibro symptoms? Doing some cursory literature search found that it’s plausible, at least, so I’m also going to start on Fenofibrate to lower my triglycerides and hopefully get my body in some sort of balance there. He’s also ordered some more labwork to see if I have any gaping vitamin deficiencies.

Have I mentioned how much I cherish this doctor? Of all the doctors I’ve seen, this is the only one where I feel like he actually listens to me, doesn’t talk down to me, understands that I know my body and have done my reserach, and is willing to try things to attempt to treat these complex, deep-seated issues that have caused me problems for the past 25-odd years. It’s a lot easier to be patient as a patient when the healthcare provider treats me with respect like this.

He’s definitely a rare breed.

Ketamine 4.1

On the plus side, my focus is way higher, and my anxiety is the lowest it’s been in a decade.

On the minus side, my chronic pain still sucks a lot, and this is still making it very hard for me to do my job.

It’s still been a huge net benefit for me though. And supposedly it takes a little while for ketamine treatments to have an effect on chronic pain. I’ll get there eventually.

Lo-Fi Beats at a New Lo-Fi Price

My album crowdfunding project was going a bit more slowly than I’d hoped, but thanks to the Qrates support team we were able to come up with better pricing, and now it’s only $29.50 a copy.

Unfortunately, Qrates is unable to simply lower the price of an album, they had to cancel all of the existing preorders, so if you were hoping to buy a copy, you'l need to redo your preorder… but on the plus side now the price is much, much lower, for the same great double-length album!

I hope this makes it easier for folks to join me on this lo-fi coffee journey.

Thanks!

Closure

It has been over 10 years since the person so many of us knew as Findra passed away. I haven’t spoken much about them or the circumstances of this horrible, tragic event, which has filled me with so many complex emotions for so long, and these feelings have been destroying me. I know that Findra would not want me to be suffering in this way.

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Ketamine 3.6

Oh yeah, another thing I keep forgetting to mention is that when I feel the ketamine really kick in, it feels like the death part of a death poop from hell. Like, everything is just… ending, and I feel it first in my hands and feet and then it’s a wave that just washes over me.

It also reminds me a lot of a time back in 2005 when I got severely dehydrated and passed out on the sidewalk and got a mild concussion, like I felt like I was dead and that’s okay, everything was calm and peaceful and quiet.

The transition from waking/conscious to ego-death is a bit jarring but once you get there it’s quite lovely. The return to reality can be pretty rough though.

Ketamine 3.5

Yesterday’s infusion left me feeling a lot more wobbly than usual today, but it was also a huge increase in dose. I ended up going to Taco Bell for lunch since it’s the only place within walking distance (EDIT: not actually the only place in walking distance but the quickest and easiest option for food near my home that I don’t have to prepare myself), and I decided to get a lunch combo, and in my haze I decided to make my drink Mountain Dew Baja Blast, which is rather high in caffeine.

So, on the minus side, I now have the strongest caffeine headache I’ve had in about 10 years when I first had to go cold turkey on it.

But on the plus side it’s just a caffeine headache, and not a panic attack!

I think this is evidence that the ketamine treatments are working, and maybe this means I’ll be able to go back on Adderall when this is all over with.

I don’t know if this has done anything for my chronic pain just yet, but those things are so interrelated anyway. So this is pretty promising in any case.

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Ketamine day 3

Today was my third ketamine infusion. It was intensely cozy.

Commonalities with previous infusions:

  • Felt like I was a tiny speck and that all of spacetime was collapsing down into this liminal space that I was part of
  • I do have a physical body but it’s indistinct from everything around it
  • Lots of trees
  • Surrounded by fractals
  • Everything is impermanent and any fears about me dying were quickly dispelled by me feeling like the universe is fine and all grief is transitory
  • Everything is so out of order and I wish I could bring a video recorder inside with me so that I can review it later and share it with others
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An open letter to Gov. Jay Inslee

I have some concerns about the way that taxes are being levied against owners of electric vehicles.

I have recently acquired a used Nissan Leaf to replace my internal-combustion engine vehicle. I opted to do this replacement specifically because I don’t drive particularly much, and I wanted to reduce my environmental impact primarily for maintaining a vehicle that I only drive minimally.

It is very rare that I drive even 1000 miles in any particular year, and usually it’s more on the order of 250-500 miles. As such, I was typically buying around $50 worth of fuel in a year, as an upper estimate.

So imagine my surprise when I got my first car registration tab, and was on the hook for $150/year in a gas tax offset! Given that the Washington State gas tax is assessed at a rate of around 13% of the cost of fuel, that’s a personal increase of around 2200% for me.

On top of that, the additional $75/year surcharge for building and maintaining more EV infrastructure is a bit shortsighted. I definitely believe that EV infrastructure should be developed, but it should be as an incentive for people to switch to EVs — meaning that it should be assessed to drivers of internal-combustion vehicles, not those of us who have already invested in making the switch. Or, at the very least, should be applied to the vehicle registration fees for everyone.

This infrastructure fee is even more concerning when the proposed charging costs will be the same as the commercial stations, the reason given being that they do not want to compete with private enterprise. In that case, why even bother providing a public infrastructure option, instead of simply encouraging more private charging stations to open up, or encouraging individuals to make their infrastructure available to others on services such as PlugShare?

The current tax structure is actually disincentivizing people from making a switch to electric vehicles, and only puts even more of a burden on those of us who have decided to help the planet.

Just to be clear, I do absolutely agree that those of us with EVs need to pay our fair share in maintaining road infrastructure. But it needs to be a fair share.

Thank you for your consideration.

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Ketamine day 2

Had my second infusion today. Higher dose, but it was a lot more cozy. Felt like everything is temporary and that I was a tiny speck in an infinite universe, and the universe is okay and I’m glad to be in it.

While things were starting out I realized I’d forgotten to put my phone into do not disturb mode and I was able to direct the meat puppet to ask the nurse to set it, and that worked well. The meat puppet was also able to take the shoes off when they were feeling uncomfortable.

Playlist was Ambienteer - Arrival followed by some Bonobo which started up just as the trip was ending.

This definitely gives me a different relationship with my body.

Anyway the euphoria has worn off and my pain is back. Oh well.

Some vague thoughts about ketamine

I had my first (of six) ketamine infusions yesterday. It was at a lower dose, mostly to see how I respond to it.

The actual experience was very interesting. Because of the combination of sensory deprivation and the ketamine itself, my sensory experience was limited to what I could directly feel around me, which mostly meant feeling the inside of my mouth with my tongue, and to a much lesser extent feeling the chair I was pressed into. So I sort of felt like my “universe” was the inside of my body, but also a void of nothingness.

I felt like my body was dissolving away and was everything and nothing at the same time, and that my self in the “real world” had ceased to be and that was also okay.

The music I chose had a very strange effect. Many of the sounds were very vocal-adjacent and I felt like they were literally speaking to me, with words I couldn’t understand. For my next session I’m going to use something more abstract and ambient, probably Ambienteer’s work.

During the experience I felt like the universe was infinite and infinitesimal at the same time, like everything is nothing and vice-versa. I kept bringing back my litany to stay grounded and intentional: “I am here to reduce pain, reduce agony, and increase comfort.”

Much of it reminded me of one of my early experiences with cannabis.

At the time I felt like I experienced something extremely profound, and that it would give me plenty to think about. But my cynicism has set in and I’m not feeling like it was life-altering, just that it’s the random nerve firings that happen when a big chunk of the brain is shut off. Ketamine treatments are supposed to work by “helping to create new neural pathways” and I’m still optimistic that repeated treatments and increased dosages will maybe have a beneficial effect.

When I woke up today I had the lowest level of pain I’d had in decades. But as soon as I started working, the flare came right back.

But the lowest level of pain in decades is nothing to sneeze at, and maybe it’s a preview of things to come.

I just hope it’ll all be worth it. This is taking both a lot of time and money, and so far feels like it’s just an excuse to trip balls while calling it “medicine.”

But if this doesn’t work I have no idea what the fuck I’m gonna do.

The frustration of continued existence

My week off from work felt great. But I’m still having difficulty actually focusing at work. I have a bunch of paths of exploration to examine but none of them feel, y'know, right right now.

Meanwhile, my house continues to be a bit more work than I expected. On the plus side, I’ve successfully murdered my lawn and vastly improved my garden and started up my nice meadow. On the minus side, my heating bill is through the roof (literally) and I’ve been getting bids for finally improving the house insulation. So far I’ve had three bids which went thusly:

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