The people I know with radiant, flawless skin all use Asian-style skincare with a meticulous nightly regime of like 10 syrups, oils, and unguents.
Everyone I've ever met who says that people shouldn't use shampoo/lotion/face wash because it makes the body stop producing oils has been NOT as attractive - putting it kindly.
Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.
I was on a 90 day prescription for ten years (vyvanse) when I told my doctor I was traveling abroad.
Insurance doesn’t cover 90 day bottles so it was $300/mo but worth it.
Nowadays there’s generic Vyvanse which is much cheaper so it probably makes 90 day prescriptions financially viable?
I just moved back to the US and had to find a new local doctor who gives me 30 day scripts so I haven’t asked about 90 day yet. I imagine these pill mills are pretty stingy. It takes a lot of time and calling around to find docs who don’t treat you like a fiend in some way.
But we need to count our blessings. People on pain killers need to put up with crazy shit like getting randomly summoned to the office so they can count your remaining pills.
> I just moved back to the US and had to find a new local doctor who gives me 30 day scripts
You may have difficultly getting a 90 day, both the doc and pharmacist have to agree to do it - 3x30 day with 'fill on dates' is more likely.
When I had a long out of town trip I was able to get a 60 day script. When I came back the doc sent 60 day script again but the pharmacist wouldn't fill it and only allowed it because what ever code/note the doc added about long term travel. That was self pay so I wasn't even a risk for selling it. Some states won't allow more than 3x30 day.
I am surprised you got name brand vyvanse for $300/month, generic is ~$250/month without coupons/discount cards
Interesting. I got a 90-day bottle from a doc in my hometown until 2022. That's when I moved back to Texas but didn't want to drive all the way to my hometown anymore to see that doc.
Now I go to some "psychiatrist" pill mill where they made me take a BS $200 computer test to diagnose me with ADHD (CYA even though I've been taking this drug for 16 years) and they ask me the same goofy questions every televisit (probably more CYA).
Yeah, it was $1000-1200 for 90 pills of Vyvanse all that time. GoodRX only knocked it down $200 or so. And the website coupon only applies to 30-day.
Now with insurance, Vyvanse is $100 for 30 while generic is $10.
This is why a friend of mine lies about their dosage. They claim they take 10mg twice a day when in reality they break the tablet into fourths and take 5mg total a day. Now they have a stockpile that gets them through frequent shortages and long trips. If their doctor asks why they haven't visited in a month and a half they say they don't take it on the weekends sometimes.
Mail order pharmacies (though insurance companies) are more likely to fill a 90 day stimulant script in my experience, solely because they really want to send out 90 day supplies for everything for whatever reason.
I get 84-day supplies of Concerta through ExpressScripts. They send them signature-required (unlike other Rxs I get from them). It's a bit of a pain—I usually end up having to go to the post office to pick it up—but it's an order of magnitude easier than needing to get a refill at a retail pharmacy every month.
I regularly travel for 4-6 months at a time and I have several prescriptions that I must take daily for years/decades and they’re not even controlled substances. Getting >60 day supplies is like pulling teeth.
It’s the same thing for me and Klonopin and my psychosis. The Klonopin is the only thing that stops my psychosis yet they only give me 20 tablets at a time and since I’m homeless and driving around it’s really hard for me to get a new doctor and a new prescription. I’ve been taking it as needed for over nine years and they still can’t get it through their thick heads that I’m not gonna abuse it.
I was in the hospital after surgery and was being treated like an addict who was just there to get pills. It was madness. Like I willed by appendix to burst so I could get a little morphine or a xanax, that makes total sense.
Yes, I have schizoaffective disorder, Asperger‘s, and myofacial pain disorder they put me on disability about 22 years ago. I used to be able to handle living in apartments on my disability, but rent has gotten crazy so I ended up living in a van which actually ended up being kind of OK.
I have episodic psychosis. It’s not something that happens every day. And I’m seeming to manage it with some genetic and nutritional understanding I have of myself so it’s not that much of a problem anymore. I just have to be careful with Covid because both times I had Covid I had the worst psychosis of my life.
All my disorders are mostly due to a CBS Deficiency.
You have to go into a doctor every month and get a new paper prescription for hormonal birth control? In the US? 20 years ago, my wife was able to do an electronic prescription, and it automatically refilled at the pharmacy every month.
For stimulants, they can't do an electronic refill, so I literally had to go to my doctor, get a paper prescription, then drop it off at the pharmacy, then come back a few days later (because it's usually backordered) every 30 days.
Some doctors would write 3 prescriptions with a "not before" date, but others were not willing to do so.
Or how every month the brand changes or you get a slight variation or they give you half the pills but double the dosage, where all of these things requires a consultation with the pharmacist and it's always a 5 second conversation: "This again?" "yep. Any question?" "no" "Have a nice day"
For the last few years I think the actual medication I take changes every month. Is it just amphetamine? Just dextroamphetamine? Both (like Adderall)? These aren't the same and effectiveness is at different dosages. And then I got to figure out how to adjust to the specific version and batch as the manufacturing tolerance is within sensitivity range. Not to mention food interactions. And most of this is a solvable problem!
At least with time release now there's less of a problem of having to sneak to the nurse's office every day at lunch to take medication and have that brat from third period ask you why you're in the nurse's office and what you're taking.
> Since you may sell them if you get them more frequently. Now here's a pack of 30.
But it's already a C/II class medication so the name on the Rx has to match the name on the photo ID and the pharmacy has to keep the records / there are rules for how often C/II medications can be dispensed. If you have a 30d Rx, the soonest you can come back with an Rx for that same medication is ~25d.
Regardless, does it matter if I have to re-fill every 30d or every 90d? As long as I'm only in there every 80d to get my 90d supply topped up, how is that any different from a 2d Rx or a 30d Rx being filled every 1d or every 25d?
Sorry, I was being a little tongue in cheek. My wife is on Adderall for ADHD and the renewal thing is frustrating for sure. Our pharmacy would only let us refill her prescription the day of until our psychiatrist wrote one that said 30 tablets over 25 days. So I get the frustration, I just find it kinda silly that there's all these overblown controls, and then they give a "large" amount when all is said and done. Kinda like security theatre to me, it's just dumb and punishes people that already have a hard time keeping up on appointments and paperwork due to their health.
I'm pretty ignorant of how all this works, never having had to take medication, so I apologize in advance if this comes off the wrong way. But isn't the reticence of doctors a result of the over-prescription of opioids leading to the very serious opioid crisis?
Not sure what the correct solution is, but on the one hand we don't want doctors to overprescribe, but on the other hand we want doctors to liberally prescribe without re-checks to make it easier for those who need it to get their meds. That would seem to put providers in a bind.
This is why I stopped, when I was starting doing internship at my job I was earning "1000", to go to the psychiatrist to get a prescription it'd cost 250, and the 1 month of pills would cost another 250, half my salary in this bullshit... on top of having to go every month which on itself is a burden.
Nice joke really, even after I started earning more after the internship period ended it was just too annoying so I stopped entirely, instead since it was work from home I literally spent 24/7 trying to finish my work so basically, "working" (if you have adhd you know that while you procrastinate, you aren't actually "relaxed" enough to go play games or whatever so it'd basically still being in work mode mentally) 16 hours a day.
Yep. For a while there I was able to work with my doctor and pharmacist to get Adderall from my Kaiser health plan pharmacy in 90 day increments but that stopped with the med shortage. Now that the shortage is over they won't do it again. Neither my doctor nor pharmacist know if this is an actual regulation change due to the shortage or just a health plan policy change. If it's a reg change, it'll never go away. If it's a health plan policy, maybe there's hope.
The problem is that Schedule 3 meds can't be shipped and must be picked up in person at the pharmacy (where driver's license # must be entered in an extra procedure not required for other meds). Health plan pharmacies have lines, don't have drug store hours and aren't on every corner. The combo of "in person pickup" + "30 day limit", which were enacted by different people at different times for different reasons creates life disruption and a massive waste of time, energy and money (we're all paying for this in increased prices). I've been on these same meds like clockwork for decades. In such cases they should relax either "in person pickup" or "30 day limit" but, we all know, it won't happen.
And if I need to travel on a trip or vacation for a week or two, with the 30-day limit there's a 25-50% chance I'll run out of meds and getting special dispensation to refill early requires contacting and coordinating the doctor and pharmacist in a non-automated, out-of-band loop. There's a two day automatic grace period to account for the pharmacy being closed on weekends but when my 30-day window falls on a weekend, I now have to coordinate pickup on an exact day - like I don't have a life outside of this bullshit. All just to get the meds which help me function normally.
Being forced to deal with all this for years has made it so I understand the health plan's back-end IT system capabilities (and lack thereof) better than most of their employees. It's still inconvenient for me but I'm one of the lucky ones. My meds are dialed-in and working, I have a flexible schedule and can parse bureaucratic systems. I got diagnosed and stable on my meds back before every ADHD patient was automatically considered a suspected drug abuser - which is ironic because I've never even had a drink, much less used illicit drugs (ADHD and alcohol/rec drugs tend not to mix well and I was diagnosed as a child). Which makes it meta-ironic I'm required to have a drug screen blood test every year to verify I am taking my prescribed drugs and not selling them - as if I got diagnosed in 4th grade as the ultimate long con knowing these meds would become street drugs worth a buck a pill decades later. I can't imagine a new ADHD patient still struggling to find the right med and dosage trying to figure all this out without giving up.
Are we talking Adderall? I would be amazed if it still works at all on you. It seems research is showing that stimulants work for ADHD, until it doesn't. If it is Adderall, do you cycle on and off, or what's your protocol? (curious is all)
Yes I did. It doesn't hit like it did when I first took it, but that decline quickly leveled off. I think it also helps that I don't take it on the weekends.
Except the data repeatedly bears out that younger generations are spending more and more time online and in isolation.
The idea that the internet remains the province solely of a few loner geeks is a total fantasy. Reddit is one of the most popular websites in the world.
Also, I was a shy nerd in high school who used reddit, and I still partied. Fuck, I made my own booze to take to parties.
Meanwhile my youngest brother - who is super social - graduated high school in the last few years and reports that partying is totally dead compared to my day.
It’s different because licensed code on github and other websites is different from freely given code snippets on stack overflow.
A blog post is not permission to reproduce code with small changes. Neither is posting it under an open source license which usually require attribution.
That’s funny, I guess everyone just ignores that, but legally it means AI should not be trained on it either since it requires attribution, I wonder was it always that way?
I think AI companies are just trying to ignore IP laws entirely, perhaps they’ll get away with it but there is bound to be a case where a small tool or game is 90% identical to a source reference at some point given the way these LLMs work.
I bodybuild, and when I'm lifting hard -- especially peaking volume at the end of a mesocycle -- my body CRAVES sleep. I'll fall asleep as soon as my head hits the pillow and sleep 8 to 9 hours basically straight through.
Another benefit to paper books, in my experience, is it's a lot easier to remember the rough location of a particular passage (towards the front, middle, near the end, etc.) than with digital
A progress bar really doesn't replace the context of the stack of pages behind and ahead of your current page.
My own personal anecdata on this comes from being able to find a passage I read in a 500-page book in 1992 for a class I was taking in 1998. I could probably even find that same passage now if I were to walk across the room to the bookcase where I have that book.
Although on the other hand, I was also able to turn up an article I’d read online a couple years later when it was relevant to a friend’s relationship with her newly out trans kid, but it was definitely a different sort of recall and lookup happening in the latter case.
While physical "progress bar" is much easier to remeber than digital one (on the side of the screen for pdfs), because you actually interact with it the whole time, i don't find (ha) finding a particular passage hard without it.
I personally usually can remeber a phrase or just a word and search for them in a PDF to find the needed passage.
It's pretty easy to highlight passages with most e-reader software. Some even let you write a note that goes with the highlight. You can then look through a list of all highlighted passages.
It's when something comes up and you remember that you read something relevant in the past. In most of those cases it's not about "Ah, this is something I may want to check again at a later time, so let's highlight it". So, there's no list of highlighted passages to search through.
Indeed this is one of those things I miss about paper books. When the above happens I have a terrible time finding that on my Kindle. Most of the time I'm not able to, while with a paper book I didn't have that problem, mostly.
I intentionally do a bi-modal system. Digital content can live forever and be everywhere, which paper is easier to capture but harder to sort and search and transmit. Digital notes are forever, and searchable, and likable, etc. Digit notes store things I have decided I want to remember forever (or things like URLs that are already digitized).
Everywhere I exist, I keep a legal pad - but any notebook will do. Near the couch, at my desk at home, at my desk at work, etc. the notebook is a list of facts/todos/whatever - each one its own line, and it gets crossed out when not relevant either because it’s done or I’ve decided I don’t care anymore. Literally like “don’t forget taxes” or “email John” or “bug at library X file Y line Z”. If enough items on a page are crossed out, I rewrite the items on a new page and rip that page out. Throw it away. Paper is ephemeral, and temporal. I typically go through at least page a day when working at my desk. Whenever I’m bored and procrastinating, I’ll read through the notes. They remind me important things I’m thinking about that I can’t keep top of mind. Anything particularly important I’ll cross out and write up digitally in my digital notes.
Importantly this lets me meet the information where it is. Work notebook is mostly work notes. Home notebook is mostly home stuff etc. there is no timeline or formal system to copy things over. If something was deadly important, I might take the time to digitize it immediately but generally a pen and pad favor speed of capture with minimal opportunity for distraction.
I sometimes write down notes in my reMarkable notebook (and sometimes just paper as well) as interim storage, but then transfer the notes to Obsidian when I have more time available to me.
All the different syncing tools help as well.
I do mostly electronic, but still let myself use a notebook and just add a date to the top of every page. I find it helps me to know I _can_ re-order and contextualize things in the future if I want, even if I never actually do.
I tear them off and put them in a filing box in hanging folders labeled by month. The nice thing about tearing them off is that you can pull out the sheets that you might need while you're working on something. Sometimes I just spread out everything I need on the floor so I can see it all at once. I've got a keeper clipboard that usually just has my legal pad and pen in it with a calendar sheet and all the task sheets that it links to, but sometimes I have to refer to things from years ago so I may have a few sheets from 2016 or whenever when I'm working away from home.
If you do use this method, I should add that when you link to a note, you only need to add the significant digits to the link. For instance, say you're making a list which has the timestamp 202403261200. One of the list items has a link to another note, say, 202403251123. Instead of writing out the full link, you just write [251123] since the only difference between the links of the paper you're writing on and the paper you're linking to is the day and time fields. Later, when you read the shortened link, you know it must share the same year and month as the sheet it's written on.
Another thing. Try using a calendar sheet for each month. I carry around the current month and at least the next three as well. Each event on the calendar links to a sheet that has all the info I need for that event. This has been enormously helpful for me. It helps if you use graph paper legal pads for this so you can draw the calendar easily.
The people I know with radiant, flawless skin all use Asian-style skincare with a meticulous nightly regime of like 10 syrups, oils, and unguents.
Everyone I've ever met who says that people shouldn't use shampoo/lotion/face wash because it makes the body stop producing oils has been NOT as attractive - putting it kindly.