Well, can't help you with crying at movies, as I practice tai chi and qi gong daily and am still a sucker for those cheesy moments.
But, when I was in your shoes I did a lot of experimenting with different practices such as yoga, meditation, etc. There are all sorts of great free classes and groups around Seattle such as Shambala on Thursday's and Insight society on tuesdays. Try a couple practices and see which one feels like a fit. Then, pick a time each day to practice for 10 minutes and dedicate yourself to doing your best to stick with it for two weeks.
I also highly recommend The Mindful Way Through Depression as a great resource for effective introductory practices as well as awesome writing about how low emotions effect our body/mind.

Whenever I get my Vitamin D levels checked (which is annually, as I tend to be deficient), I have to have a single vial of blood drawn. Finger pricks are good for blood sugar and white cell counts, but not so good for quantitative assays, especially if you need several different tests.

What do you mean by having a hard time with blood tests? You faint, or your veins are tricky, or you have a needle phobia? If you tell your doctor, s/he can usually help you with those concerns.

Tiredness can also be environmental (new street light or loud apartment mate) or a hormonal problem (hypothyroidism). You need to go to a doctor, be upfront about your problem, whatever it may be, with blood draws, and potentially get prescribed a multivitamin and a chat with a nutritionist.

One of the symptoms of depression is disturbed sleep. However, disturbed sleep can also lead to depression. Do you snore or thrash, by chance? If so, tell your primary care provider as you might have a sleep disorder. Also, does your doctor know about your use of melatonin? It can interact in weird ways with antidepressants, so please discuss with your doctor to make sure that you aren't experiencing side effects.

Do you exercise? If not, you should, and if so, do it earlier in the day, like right when you wake up. It'll temporarily wake you up, but you'll be more tired by the end of the day and in theory better able to sleep. If you exercise hard enough, you'll be too tired to ruminate, which is probably what you do before you go to sleep.

Light therapy is another option. If you get a therapy light on a timer, you can get some more sun-like light, which should help you adjust your schedule back to a more normal one, and it'll also help with SAD.

You're getting your 8 hours, just not in the best time of day to sleep. Transitioning to an earlier bedtime and waking time shouldn't be done abruptly, but you don't want to get to the point that you're naturally on 3rd shift if you can avoid it.

In my outpatient mental health job it means the level of services that the county is paying the agency for. There are 3 tiers that we use: 3B, 3A, and 2X and it just means how many hours of mental health counseling and case management you get per month from around 20 down to 4 or so. Tiers are determined based on need. I'm not really sure how it related to inpatient hospitalization...

You don't have to talk. That is never an obligation. You don't have to do the: Hi, I'm ____ and I'm an alcoholic. Go to an open rather than closed meeting at first (which means other people who aren't alcoholics can go, like friends and family, random people off the street, whoever). Go to a large one rather than a small one if you can, makes it less intimidating if you are just one small part of a crowd. Agnostic is fine, it depends on the group and where you live but generally there is just the Serenity Prayer thing they do at the beginning and after that whatever people say about their beliefs etc is up to them, most of the people there tend not to be very much on the religious side where I'm from anyway. The belief part is generally interpreted not as a specific belief in God in the Christian sense but as a belief in some positive force outside yourself. There are lots of different meetings so if you don't like one group, go to another. You can show up late and hang out in the back and leave before it's over if you are that allergic to the serenity prayer thing, it also minimizes other contact. Depending on the group they may make some effort to reach out to you (esp. if the meeting is closed, if the meeting is small) as they will assume you are there for some kind of help. Usually they will encourage you to come back, or call anyone on their list of people to call if you need some help, and if you show up more than a few times probably encourage you to find a sponsor if you want to seriously work on things. If you don't want to deal with this you can say you are there to better understand a family member/friend or are just there to listen and are really shy, and duck out. I went to AlAnon myself for a year or so and never spoke (and it was small groups), and I'd go to AA meetings to better understand a family member from time to time, and never got talked to either (my choice though). People are very respectful of body language, and they are trying to very hard not to scare you away. There is often also a snack/coffee break where people might casually talk to you (or not), you can try to avoid this by going outside, though a lot of AAer's smoke too, so if you are terribly socially phobic you may have to leave at this point, or hide out in the bathroom. There are different formats for meetings, and different topics they work their way through, but if you are lucky enough to go when someone is telling their personal story at length it's usually worth sticking around - the AAer's have MUCH better stories than the AlAnoner's.

I'm king of the asthmatics. That I am alive at all is amazing. I'm allergic to nearly everything (except dust mites), have been intubated and my parents flown in from Jersey because I was pretty much dead from my asthma. Deep coma, anyway. Some days I have to stay in bed with an air cleaner and prednisone at the ready though flovent has been a god send. I use advair 250/50 and spike it up to 500/50 or even 750/50 or more when things are bad.

Monday morning call Dr. Kirtland of Virginal Mason hospital at (206) 223-6622 and make an appointment. This doc is awesome. Virginia Mason is awesome. Best doc and big hospital experience I've ever had.

Really. And all testing necessary can be done at V M which is a big deal.

Good luck.

I have no expertise, except that I've lost a good bit in the last year. I can only say that it hasnt been easy, but I'll tell you what little tricks seem to have worked. They're not much different from what you're doing, so I'll make it short.

1) portion control has been key, and the usual tricks (small plates, freezing meals, and doggie bags) really do help.
2) calorie consciousness has really been useful, but I can't bring myself to count calories in an ongoing basis. Spend a week getting to know what's what, as I found out some hugely caloric things that I wouldn't have guessed, and can easily do without.
3) this may just be my own psychology, but weighing myself daily was a terrible thing, since even when I was doing well, my weight would fluctuate (presumably due to hydration or muscle gain?), and I'd get discouraged and undisciplined. Once a week solved this.
4) avoiding sugar and alcohol is a great idea, and I know it seems difficult at first, but try going a week without, just as an experiment. I found it easy once I got a few days into it, and after a month, really lost a lot of weight. Now I'm on it again (moderately), but that month was a revelation.
5) keep hydrated, and drink a full glass of water before each meal
6) iced hibiscus tea. Probably just me...

Good luck!

I have taken it a couple of times and I'm considering pursuing a prescription since I just started an overnight job but I'm waiting to see if I actually need it, so far it seems like not.

It doesn't make me anxious, but I'm not anxiety prone, I can drink a buttload of coffee and go to sleep, and although it's been years and years since I've taken any I'm the type of girl who really digs speed. So YMMV, especially if you are very sensitive to stimulants. That said it is nothing like adderall, ritalin, or other ADHD indicated stimulants. There's no rush, no euphoria, and no "fun"- even if you crush it up and snort it (don't judge me), unless you consider staying up all night, sober, fun. That's why it was developed. Personally it just makes me feel like I don't need to sleep when I should be sleepy but I've never taken it for an extended period of time and some people who do have noted a range of physical and psychological effects. You can read about a variety of experiences here.

I don't know why your insurance won't cover it. It's prescribed for obstructive sleep apnea/hypopnea syndrome related fatigue, narcolepsy, and shift work related sleep disorder (my all time favorite "disease", it's characterized by "night-time drowsiness and daytime insomnia") so if you don't have one of those your insurance provider may be hesitant to pay for off-label use. Or it may be because the patent on Provigil is about to expire and they want you to take the new expensive  Nuvigil instead. That seems like that's the sort of thing they'd tell you though.

Bilirubin is what makes poop brown - it's produced in the liver and goes through the bile ducts into the intestines. A day or two of pale poop is normal; two weeks is not. There are a lot of things that could cause pale poop, and some of them are serious, so you should get it checked out. It's not ER level serious but go to the doctor within a couple of weeks serious.

Call Country Doctor at 206-299-1600 - they have a 24-hour consulting nurse who can help you decide what to do. If you get really, really nauseous or start throwing up a lot, you should go to urgent care.

If you do need urgent care, go to a hospital and ask for "charity care." Most hospitals in Washington offer it; it's a lot of paperwork, but for something serious or potentially serious it probably will be cheaper for you than going to a private or sliding-scale clinic. Here's a list of Community Hospital Charity Care Policies if you want to shop around. If nothing else you can set up a payment plan.

There are also a lot of great resources at this question - How do I pay for necessary healthcare when I have no money or insurance?

Theraflu contains pseudoephedrine (a decongestant). I don't know what skin condition you have exactly, but the decongestant could be reducing the swelling that comes with acne.

I've never taken Theraflu, but I hear it's not the kind of thing you want to be downing every day. I know there are topical decongestants for noses, so maybe there's something out there for faces.

I'm not a dermatologist, but I bet one would be able to point you in the right direction.

Everyone reacts to antidepressants differently, but if you are in a serious and possibly suicidal funk, then you should definitely consider anti-depressant treatment without question.

Know also that it may take some time to feel any benefit from the antidepressant and/or you may have to switch to a different anti-depressant. Every medication works differently with each person.

I would also recommend seeing a specialist for medication management: a psychiatrist (MD) or psychiatric mental health nurse practitioner (PMHNP). Regular family doctors don't usually have the experience working with the medications for psych problems like the specialists do. Too often you find people taking the wrong psych meds, because they are seeing a general practitioner instead of someone who knows more about what they are doing.

Can anti-depressants really help? YES! Absolutely, but they don't work for everyone. I have taken several different kinds of anti-depressants and have been on Zoloft (among other things) for about 11 years. I also recently started taking Abilify, because I was having severe motivation/mood problems and it has made an amazing difference! I've been on Abilify since January. I feel a lot like I'm getting my life back. It is pretty fricking awesome!

However, you have to be serious about doing what is best for you. If you don't take the medication as prescribed or if you are going to load yourself down with other drugs and/or alcohol, then anti-depressants will probably not work. You have to give them a fighting chance to work. That also means that you would hopefully get some talk therapy as well. I really think that part of depression is biological/chemical and at least a little bit of it is cognitive. If the meds help you feel better, then it is easier to figure out the cognitive stuff.

Honestly, I think people worry WAY too much about the side-effects of anti-depressants, and often go on to have debilitating depressive symptoms, because they are too afraid of whatever side effects there might be. Of course, there can be side effects, but wanting to blow your brains out from mind-numbing depression is, in my humble opinion, a far worse thing. Even if you aren't super suicidal, being miserable every day should at least be taken seriously. You don't have to live like that. That isn't what life has to be about.

Life is too damn short to spend in misery/unhappiness.
Depression sucks donkey balls. Your life doesn't have to, thank goodness for modern medicine!

It would be a good idea to have enough rice on hand so you can rotate it periodically. You are actually heating the water in the rice kernels and if they dry out too much you won't get good lasting heat out of them. If you rotated some so that the in-between times the grain had some opportunity to absorb some moisture from the air it would be better. I am unsure about misting the grain or some other method to help it rehydrate, but you could try it on a sample (go easy, too much moisture could hold too much heat).

Tube socks work well at holding the rice in a form you can flatten and rest your arm on or drape them over the target area. You can fill them and sew over the end to hold in the rice or tie a knot in the end if it is a good long one.

Oh, yes, I had one a few years ago that a friend made for me out of polarfleece that was filled with large rock salt, like you would use in making ice cream, it worked great and wouldn't cost very much.

I did a round of Accutane in high school. It was quite effective for me, but it definitely had its downsides. When I took it in the mid/late '90's, my doctor would not prescribe it to me unless I was also on hormonal birth control. Accutane can cause particularly awful birth defects, so one of the prevailing policies of the time (I'm not sure about now) is that a female on Accutane had to be on the pill at the same time. When you opened the Accutane package, each of the little pill blisters had a silhouette of a pregnant woman with one of those big "NO" circles over it. They weren't kidding. So I got two prescriptions at once.

I had taken every acne remedy known to man at the time, including topical Retin-A. I had some cystic acne, but the biggest problem for me was that I broke out ALL THE TIME and had skin like an oil slick. The first two months on Accutane were pure misery. My skin "purged", a common outcome that results in your skin showcasing what appears to be the rest of the acne that you would have had in your life in a month's time. Nightmarish.

After a few months of leper status, my skin started clearing up. Then it was magically, amazingly clear, and not oily to boot. I did not have to blot 100 times a day. It was bliss. Then again, I had some of the oilest skin around to start, so if you've got dry skin going into an Accutane series, you will have a rough time with this stage. The difference between Month 2 and Month 3 was extraordinary. For me, Accutane normalized my skin.

Once the six month Accutane dosages ended, my skin reverted back to oily and break-out-y, but not nearly what it had been before. In short, Accutane helped me, but it was not easy, and results may vary. I didn't have any issues with mood alteration or depression, but I react ridiculously well to medication, including the hormonal birth control they made me take in tandem with Accutane.

Since you're on Retin-A now, give that a solid amount of time to work. Accutane is mega Retin-A - every downside will be magnified.

I'm not aware of anybody ever using the term "Fat Ally" or there being any organized movement like this, but maybe there should be. I have a few friends who are monstrously overweight, and I've learned a lot about the day-to-day considerations they have to factor into their lives because of their girth.

One friend of mine can't fly to visit his kids in Spokane because he can't fit in an airplane seat, so he puts a LOT of miles on his car. Another person I know has to use a disabled parking permit because of bad knees caused by weight. I never would have thought of these things until friends pointed them out to me.

It's a double-edged sword though. I want to be supportive, but there's also an element of choice involved. Gastric Bypass surgery can help people lose the weight if they are monstrously obese, but the won't do it. The reason? It's in their head. A lot of fat people have intense psychological issues with their weight.

And on that note, Richard Simmons wrote a GREAT article on CNN on why it's not OK to tease fat people, because it makes their psychological problems worse. Fat = sad = eating = fatter = sadder = eating = fatter....

So, although there may not be an organized "Fat Ally" movement, the simplest thing you can do to help fat people is to not make fat jokes, and when you hear somebody make a fat joke, just say "Hey, that's not ok. You wouldn't make a gay joke, or a Jew joke, or a black joke, fat jokes are NOT ok either."

All of these suggestions are fine, but they all are for treatment of SYMPTOMS not cures of any kind.

Kristin, feel better soon. You're sore throat may just be allergies or irritation. Netti-pots (fucking gross IMHO), and saline gargles will help relieve these potential ailments. If however you do have a bacterial/viral infection your sore throat indicates that you are already sick!

Rest is good, juice is good. Your immune system is in control now. If it is viral then sit back and be ggod to your body while it heals itself. A bacterial infection may presage the need for antibiotics.

If you have a high or persistent fever, go to the doctor.

So long as it's not on fire, dear - smell away. I love me some green army men plastic smell myself.

Math anxiety can arise from a number of different sources.

In general, the daunting issue with any math problem is that there is generally, a RIGHT answer, one right answer, and lots of ways to arrive at an answer that is not correct if you don't use the appropriate process in solving the problem.

Mathematics is a different language, expressions written in non spoken language symbols that if you are not familiar with how to "read" them creates a disconnect for the strictly language oriented person. In your studies learn to recognize what equations are 'saying'. If you can put more language to the symbols and remember the steps in solving the problem in a list of language explained processes then you can approach the seemingly confusing symbols in a logical fashion and work through them to an answer.

If you are studying pure mathematics strictly from equations and presented problems then learning and using the logical steps taught to you is the key.

If you are taking on "word" problems (those written out story problems) you have to learn to discern the critical information from extraneous facts that have been inserted to possibly confuse the problem solver. Make a list of the information you glean from the text. First, circle the facts as you run through the reading and then in the second reading cross out those you know you don't need, and make your list from that. Talk through it in your head, putting spoken language to the process helps many people.

When taking tests, realize that you are working with a quantity of separate problems. Work through the ones that you immediately see how to solve. Don't let any problem stymie you or cause you to slow down and lose confidence. Often a later problem gives you some experience or jog your memory as to how to solve one you skipped in the first run through. When at the end of the test go back and start again working on the ones you skipped. Your confidence will be higher and having answered a bunch of problems already, you know you have scored points to a passing score. You may still skip problems in the second run through as you solve ones that previously vexed you. Continue the process until you have come to the end and then go back again to the ones skipped twice. Make you best effort on all of the problems from then on out. Finally look back at the test from the beginning and observe your work, this is where you may catch an error in logic or even something simple in the arithmetic of generating an answer.

Math skills generally build from simple processes to more complex thinking. If you haven't gained mastery at one level you may have difficulty working with the processes at the next. Be willing to say you need more practice and get a tutor that you feel you can communicate with. Practice is the key. With a tutor, formal or informal, think out loud as you work with a problem so they can see where you might be lacking in understanding or in missing critical steps.

By your own admission, you are doing well. Good for you and keep up the practice!
I hope this helps.

What I'm having a hard time gauging from this question is the timespan/timeline of things.

Like, how long have you been off birth control?
How long have you been off Prozac?
Are you still taking the Wellbutrin? if not, how long have you been off it?
Is your depression adequately treated? or are you still depressed?

Since low sex drive is often-times a symptom of depression, perhaps your depression has not been adequately and completely eradicated. Even if you feel mostly better, you might have dysthymia or mild depressive symptoms that include a low sex drive. You could try augmenting your anti-depressant with another medicine that might boost the anti-depressant effects.

For example, my p-doc added Abilify and it has been a tremendous help to my Zoloft. (It also costs a hell of a lot, but luckily my insurance covers it).

People react to medications differently.

Anyway, it is hard to gauge what is going on without more info. But, keep an open dialogue with your doctor. Tell her your what you have told us--that it is an issue for you, and you want to make sure it doesn't get pushed aside as unimportant, because you are female.

I also am wondering at what age you started birth control and how long you were on it? How old are you now? People have different libidos at different ages, etc.

But, above all, try not to freak yourself out. I'm sure there is a solution for this problem somewhere!!!

I'm with you, whiskeypony. A Q-tip plunged into that canal right after a shower, nice and deep, touching all of the interior walls in turn... Awww yeah.

In fact, I think we should rename Q-tips "ear dildos," or maybe "ear-dos" for short.

My mom spent ~25 years at the VA as a psychiatrist on the "lock down" units (very sick people). I asked her this question one day.

She said in all her time working at the VA and teaching at a nearby research university, she had met only 1 person who she truly believed had authentic multiple personalities.

I guess that puts her on the skeptical side of the controversy.

No, I don't mind your asking, since I opened the door some weeks ago.

I hesitated to respond, as this is a public forum instead of a private e-mail, and I almost deleted the question... but then I thought, the hell with hiding mental illness in the shadows. People NEED to know that it's present and the LOTS of familes are forced to deal with it.

So, to answer your question, the family member is not currently on Haldol, but instead returned to Resperdol (sp?) which has worked!

Unfortunate side effect is tremors, but they have asked for something to help deal with those awful tremors,and the doctor has agreed to adjust with something else. (Sorry I'm vague here, I wasn't present for the discussion...just third hand info to relay.)

I would argue that the DRAMATIC improvement from Resperdol is absolutely worth the price of tremors. It's good to get my family member back from the brink, even if it means the sacrifice of enduring constant tremors.

Hopefully, others will benefit from our discussion here....

Tight clothing can be one cause but the general description of the condition's cause is compression of the lateral femoral cutaneous nerve as it passes underneath the inguinal ligament. (For all you guys out there, that is the ligament under which protrusion of abdominal tissue creates a hernia in the groin - "turn your head and cough" test). The extra tissue of obesity can cause this compression, but even fit individuals can experience this condition from pressure on the nerve from the saddle of a bicycle when cycling for extended periods of time, it can even be a transitory condition experienced during pregnancy.

If you are not wearing tight clothing now, presumably the issue is excess weight. So, you are correct, losing weight can presumably relieve this compression. You need to talk to a good dietician to help you come up with an appropriate diet that will be satisfying and set you up for successful weight loss by taking in the an appropriate amount of healthy calories. Use of NSAIDs or other prescription medications to relieve pain and swelling while you are working on your weight loss through exercise can help, but you should have physician advice and participation here.

As for a good exercise regimen to follow, I would suggest getting involved in a good pool exercise program for persons with your level of excess weight. Exercising in water helps relieve the stress on joints and pressure via gravity and provides good resistance to movement (walking, running, and swimming). The YMCA in Auburn has a pool with a floor that can be raised and lowered and is adjusted for water therapy exercise classes to put participants in an optimum depth for the class involved. I am sure there other such facilities around.

Get involved in a local group of folks working on weight loss so you have some support in your efforts. Celebrate the small improvements and steel your resolve to stay committed - it is a long journey and takes time. Good luck!

Our nervous systems are basically "excitable" systems, that is, they are designed to get inputs through all of the senses, all the time. In order to keep the information manageable there is functional parts of the circuitry that serve to block or "ignore" constant noise coming from our senses that serves no immediate purpose. For instance, before reading this complete sentence you probably had no real awareness of what your shoes feel like on your feet at this moment - but now you do, because you are paying attention to it with this reminder. People that have a less than fully active inhibitory system to block this "noise" are bombarded by the overstimulation of the information coming in through hearing, smell, visual movement and light, etc. to the detriment of being able to selectively concentrate on the task at hand or to a preferred channel of sensation. Certainly you can see how this would interfere with being able to function in some "busy" environments.

People who work with persons with autism are familiar with the a cheeky but descriptive term to judge sensitivity to these kind of environments known as the "Wal-Mart test" (read the section with the heading "Locked In, Locked Out"). Basically this is where some environments are judged to be so chaotic that keeping normal demeanor is very difficult for some people.

Children that are diagnosed as having Attention Deficit Disorder (with or without Hyperactivity) are often individuals that have these lower levels of functioning of inhibitory functions in their brains which is why some very specific stimulant drugs that boost those inhibitory functions work to improve concentration and selective attention. (Hence answering the seeming paradox of why giving a stimulant to some hyperactive children works to calm them and make learning and their concentration to task easier).  

Now I am not suggesting that you fall into any of these diagnostic categories. There is a wide range of normal on the continuum of considering any human ability and traits and you obviously are falling towards the end of being on the more sensitive side. Finding out if there are specific triggers to exacerbating your specific sensitivities can be a long process. You may find that some foods, drinks, or chemical sensitivities contribute to your heightened responses to general stimuli. Additionally you will discover other techniques that help you limit the confusion of overwhelming input from your senses. Also recognize that some sensitive individuals are highly prized. There are folks out there that are paid big bucks to apply their super sensitive taste buds or olfactory abilities as food, coffee, and scent testers and experts, for just one example.

However, goth jenny's response to your question is less than helpful. She demonstrates the "it's all about me", "oh, just be normal", and "get a life" thinking that demonstrates no real empathy that someone else's life and internal state could possibly be different from their experience. These folks represent just some of the hurdles you have to deal with. Good luck on your journey.

Ouch!

So, I am guessing that you got through the whole task feeling like your hand was pretty tired and overused and the swelling and difficulty in use (pain) developed that evening after a few hours of time had passed. That is versus a sudden intense pain and you had to stop in the middle.

My best guess without seeing you is the injury is to your dominant hand (the one that was gripping the back of the saw) and the damage is to the ulnar collateral ligament of the medial carpal phalangeal (MCP) joint of your thumb (that is, the inside aspect of proximal joint of your thumb - the joint closest to the web space).

You can stretch that ligament over time of misuse (called Game Keeper's Thumb, think grabbing objects and twisting the hand so that lots of pressure is applied to the joint stretching the ligament gradually) or injure it quickly with a blow that causes sudden abduction of the thumb (Skier's Thumb, think planting a ski pole and then it being stuck so the thumb is forced laterally away from the hand).

What you may have done is kind of in-between these two. You applied great pressure as you worked over that hour or so of work, felt some discomfort but got through the task. So you have stretched that ligament forcibly tearing fibers. The sudden pain scenario (skier's) leads more to the conclusion of a tear (avulse) of the ligament from its bone attachment (insertion point) which can take a bit of bone with it and would be the more serious condition requiring surgical repair. The kicking or reciprocal motion back and forth of the handle of the saw repeatedly pulsed that force against that joint and its collateral ligament so you may have a some pretty significant tearing and may have bruised the bone also.

If surgical repair is not indicated then the basic treatment is immobilization with the thumb abducted in a splint with rest and non-use. Your doctor my send you to a hand therapist for that splint to be made or fitted (hand therapists are occupational therapists with extra training in dealing with hand injuries and post- surgical care).

For the immediate care, your idea of icing and an anti-inflammatory OTC medication is appropriate. Cold pack (ice) applied 20 minutes on and 20-30 minutes off repeated (continual ice application is counter productive) and use anti-inflammatory drugs according to label recommendations.

But this is your hand (probably your dominant hand) and really really important. If things really aren't getting better fairly quickly having it evaluated by a physician would be advised. They may want to x-ray to be rule out bone damage through avulsing of the ligament. The immobilization of the thumb in the right position for proper healing is also kind of important.

Here is a link so you can read about what I have been explaining.
http://en.wikipedia.org/wiki/Gamekeeper's_thumb

If my description does not fit your injury, I apologize - kind of hard sight unseen, so to speak, but same general advice applies to immediate treatment and seeing a doctor.

File a complaint with the Washington State Office of the Attorney General.

http://www.atg.wa.gov/
http://www.atg.wa.gov/FileAComplaint.aspx

Your beef is with VM (this is not an issue concerning your health insurance policy) and that should be made clear in your narrative. Your previous records of the charges involved in the same procedure that they have performed may be important and relevant to your case.

I suggest that you write to VM and let them know you have filed a consumer complaint concerning the charges on your bill. It would probably be best to pay the fees listed on your billing that you think are appropriate and in keeping with the way the procedure has been billed in the past. Make note on your payment what exactly you are paying from the billing they sent you.

Getting the AG involved is your most powerful tool in getting an appropriate resolution to this issue you have with Virginia Mason.

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Alleve can help bring the swelling down. You may want to lay off the specific activity shown in your avatar for a few days - just sayin.

First of all: Relax. As much of a fuck up as you think you are there are millions of people out there who are far more fucked up.

I, too, am a serious fuck up. The thought of suicide has gotten me through many difficult nights. It’s comforting. Is that fucked up? Yes. Is it dangerous? No, not really. Thankfully I’ve always been way too lazy to even go through with suicide. It would take me months just to write the note. And then there’s the how. Guns seem too violent and messy. And I don’t have one. Pills are too precious to blow on such a thing and are one the few things I actually enjoy. I’m afraid of heights. I have an electric stove. Hanging seems way too uncomfortable. Self immolation is beyond my ken. My mother is still alive. Etc.

All in all suicide seems to be just the sort of pain in the ass I’ve always steered away from. I’d like to say that I’d probably fuck it up anyway but with my luck it would be the one thing I manage to get right. Ultimately, at least in my case, suicide is just an expression of my own self obsession and selfishness as much as it is about my self-loathing. And the self loathing itself is pre-emptive. There is nothing that anyone can say or think about me that I haven’t said or thought about myself. So their mockery and disgust can’t touch me.

I did have one advantage over you and that is parents who didn’t have shit and were raising three other boys anyway. I didn’t have anyone I could ride. No one was going to take care of me or let me live in their basement. That is a bit of a kick in the ass so I managed to accomplish a few things. Like graduate from college. And then I got busted for weed. And I went to jail. For weed. For six months. In a jail in Hackensack New Jersey that was built for 350 inmates but housed over 1100. It was one of those turning points in life that I was lucky enough to get. But not because of the usual narrative, I don’t think.

Going to jail didn’t necessarily just make me look at how fucked up I was or how I disappointed so many. It did, but there was more. I was really pissed that I was going to jail for a couple of ounces of weed. This was New Jersey in the late eighties. Brutal. I had ignored the risks for years and now it was time deal.

What really impacted me more than anything were the other inmates at the jail. I met people I never would have met. And I lived with them in over-crowded dormitories where you had just enough room to lie down with a crappy mat, a pillow and a blanket. Some of them were good fellows. Many were very bad. I mean stone cold bad mother fuckers. Before I got locked up I had stopped believing in evil and saw the idea as being juvenile and simplistic. I was wrong. Some of these men were evil. Fuck the “Dead Men Walking” type bullshit. There was no redemption in many of them. And many of my fellow inmates were crazy. All were poor. Nearly all were ignorant to extremes I would have found laughable just a few months earlier. The living conditions were sub-human. The food was garbage. The stench was foul. And I couldn’t fucking leave.

Luckily, I’m over 6 feet tall and weighed around 240 pounds at the time. And I am the oldest of 4 boys all close in age in a rough and tumble New York Irish Catholic family. I was no easy mark. So my physical well being was only rarely at issue. But I was outraged, shocked and humbled.

I was outraged for a lot reasons. Being in jail to begin with. The conditions. The heat. The boredom. The terror of watching other inmates get beaten down (by inmates and guards). The terror of realizing how Kafkaesque anyone’s life can get. I was shocked at the poverty of thought, scruples, and empathy as well as the general economic doom that seemed just around the corner for so many of the inmates. I was humbled because so many of them would have had completely different lives if they had half of what I was given. I no longer loathed myself as a passive, lazy piece of shit but I was now outraged that I had let myself both be the mindless and thankless recipient of all the benefits of being in a white middle class well educated social strata while also letting myself become one of its “victims” (there’s probably a better word, but it fails me).

So I took honest stock of myself. And by honest I mean I tried very hard to recognize what I considered to be good qualities about myself as well as the usual bad ones I was already intimately familiar with. This let me recognize what it was I needed to do to make my life a life worth living. I began to realize what I wanted my life to look like given the assets and liabilities I have.

For example, one of the things I recognized was that I was lazy. I already knew that. I was a classic under achiever and only did as well in school as I did because I was smart and knew how to just get by. Whatever it was I managed to get it done with a borderline level of competency. Thing was, it didn’t really matter how difficult the job was. If it was an easy task, I did an OK job. If it was a very hard task I did an OK job. Doing an OK job on a hard task is much more fulfilling than doing an OK job on an easy one. I began to challenge myself by taking advantage of everything I could. I was the first person to ever be let of that Hackensack jail every day on a work release type program so I could go to grad school. I cleaned the shit out of that dormitory after the last riot because that was job I was given. That particular riot was nasty and was the result of the inmates not getting the toast we were accustomed to on Sundays. Really. they ripped out all the toilets for that. The toilets! Our toilets!

I also made a list of my ideals. Of what I want. My values. I wrote essays to myself to clarify my thoughts. I applied for jobs I knew I didn’t qualify for because they seemed so cool. And I actually got a few of those jobs. Doing things like watching a nest of bald eagles in Arizona. Great job if you're lazy. Leading birding walks as a naturalist in the Berkshires and White Mountains. Awesome job if your lazy and most of the folks on the walk are senior citizens.

I can assure you I am still lazy. I can still make the Dude look like an ambitious, ruthless man of industry. I am still inclined to corpulence and prefer to read about life threatening adventures than actually do them. I still go through bouts of doubt and self loathing. But I had gotten to my bottom and I had nothing to lose. Like you. Mine was a bit deeper, maybe, or more intense; certainly more based on terrifying legal consequences than where you find yourself at. Nonetheless, my advice is the same. Take stock. Determine what it is that will make you happy. I think it is self respect that will make you happy. So take chances. Big chances. You say you are suicidal. That means you have little to lose. You are free to do what you want even if what you want to do is nothing. But doing nothing is rarely the path to self respect so pick the next thing.

Sorry to ramble a bit. I didn’t mean to be so verbose. But I recognize much of myself in your post so I hope you may be able to benefit in some small way from my story, as abbreviated as it is…

I'm not a doctor, so you should probably check with a real one (and not Dr. Google either--go to an actual, live doctor) to verify this information. Here's what I remember from high school biology class about what happens when alcohol and prescription drugs mix:

1) If Abilify is processed by your liver, the alcohol might be staying in your system longer without being broken down. When you keep drinking at a steady rate throughout the night, you might keep getting more and more drunk because each shot takes longer to leave your system.

2) Many antidepressants are synthetic versions of the same feel-good chemicals you get when you drink (the names I remember are serotonin and dopamine, but there are more). It's a complex and delicate system, which is why you probably had to go through a long process of finding the right medication and dosage for you. Pouring a bunch of alcohol on top of those carefully balanced chemicals can have unpredictable results.

3) The effects of mild drunkenness could be combining with some of Abilify's side effects (drowsiness, maybe?) to produce a severe reaction.

Tl;dr answer: Stop drinking, and if you can't stop, talk to a doctor about whether another medication would be a better fit for you.

I strongly recommend that you read "The Promise of Sleep" by William Dement. It's pretty much the best layperson's guide to sleep science that you'll find anywhere.

As far as your specific question goes, your basic intuition is right, but unfortunately, it's not quite that simple. The average sleep cycle length is 90 minutes, but for different people, it can be as low as 80 or as high as 120. And often, sleep cycles increase in length during the night.

However, there's a much more important concept, which is sleep debt. For every two hours (approximately) that you're awake, you incur an hour (approximately) of sleep debt. Normally, you repay your sleep debt each night, but in our chronically underslept society, there's a good chance that you're carrying around weeks/months/years of debt.

So my real recommendation is this: Give yourself time for 9 hours of sleep each night. For a while, you'll probably sleep the full 9 hours, because you need it. Gradually, you may find yourself waking up after 7.5 or 8 or 8.5 hours and not feeling tired at all... in which case, congratulations, you've found out how much sleep you need!

Another note: If you snore, or ever feel tired during the day, get yourself to a sleep medicine clinic. Sleep apnea affects between 5-20% of American adults. Treatment is simple, but untreated apnea can shave 10-20 years off your life. If you're feeling groggy in the mornings -- especially if you have a dry mouth, sore throat, or headache -- you should investigate this ASAP.