The Naked Eye

I got a little extra time, but it's being redeployed immediately to clinical time. We finished our psychopharmacology class, which is abbreviated (ridiculous -- it needs to be a full-semester course) so I can stay at ASH all day on Wednesday instead of running off to class at 4:00. Last night I stayed until 6:00, so this could work out well. Get even more hours in, then December won't be miserable. Anyway, last week I spent one day at a Psychopharm conference that UT put on - it was an utterly huge room of people interested in this stuff. Here's the sessions I attended - really fascinating: placebo response, bipolar in kids, new psych drugs, treating refractory schizophrenia, and alternative therapies in depression. The one I found most interesting was on new psych drugs, not because of the new drugs planned (there basically aren't any, which is a real disgrace), but because the man teaching it put up so many helpful charts on choosing the right drugs, particularly antipsychotics, from all the choices. And people - take your Vitamin D. Every day. 

Nile is a black belt now in Tae Kwon Do. He is technically a black belt candidate, which is the first level, but - hey - the belt is black. It counts. Dani blew into town for ACL, with her bright red ombre'd hair tips. She's back in NYC now. I barely got to see her, but my sister Holly and I did get to take her to dinner the last night. We talked about Holly's twitter guy - this is interesting. Holly had been following the tweets of a cool guy on twitter, she was in Vegas & discovered (via a tweet of course!) he was too - they met up, hit it off, and now they may have a thing going. He's coming to Austin to see her. It's just so fun to say "your twitter boyfriend", I hope it works out so I can keep saying it. Ah, the new rules of dating in our networked, social media, 24/7 age. 

So on my first exam in Advanced Psychiatric nursing, I think I was the only person that passed, and that was by 2 points. Really. Ridiculous, I was mad for days about that. Then she gave us all a monster curve, and everyone passed. Yes, all us morons had to be yanked by our heels to the "acceptable" line. I was under a silly illusion that things like that wouldn't happen in grad school. 

Now I'm going to comment on a couple of juicy news items that I can't resist. First is this fungal contaminated steroid injection problem. A compounding pharmacy sent out vials of injectable steroid solution that were so contaminated with a fungus that you could see particles with the naked eye, according to the NPR report I listened to. I have noticed that medical professionals that I've dealt with in general are very against these compounding pharmacies and what they are doing. In my class that covered supplemental hormone treatment for women (compounded "bio-identical" hormones are all the rage), the lecturer flat out said this stuff is bad, there are absolutely no standards and no monitoring, they can put whatever they want to in there, and there's no guarantee of purity or strength. Or apparently of safety.

The other thing that caught my attention is the Lance Armstrong story. It's not playing out like I expected. I really don't understand why, after all these years, they are doing this. Now you may think to yourself, "because it's true" -- well, maybe it is, I certainly have no way of knowing it, but Lance won seven Tour de France titles, the last being in 2005. That is seven years ago. I can't believe that they had investigators working on this for seven years. Just seems to me like there should be a statute of limitations for them taking your medals away. I have to add that I have tremendous respect for what Lance has done with his LiveStrong Foundation. Did you know he started that before he won his first Tour? How many celebrities do that before they hit the big time? Hell, how many do it after they hit? Anyway, I don't like how this went down. It's just wrong. But one thing makes me happy - donations are up at LiveStrong. 

My clinical days are intense. I am at two sites that couldn't be more different - the children's unit of the state psych hospital and then a private therapy office. I literally go from seeing the most challenging, saddest, difficult to treat cases of kids with profound mental illness to sitting in a quiet, comfy little office listening to a couple talk in quite tones about improving their communication. It's hard to keep perspective at times. And I find this tidbit interesting - the kids that I see at the state hospital, in my opinion, are getting better care than they would at a private hospital. I would even say much better. Mostly because they don't have the mad dog insurance company snarling and growling at them to hurry up and discharge the patient. Most patient stays are at least two weeks, I've seen many longer, sometimes months if there's significant placement problems. And let me add, these kids need that time. OMG, I had one really bad day in treatment team review where I listened to so many stories of troubled homes. Thank goodness that is not every day, and certainly not every family. So when you hear "state hospital", don't think snake pit or that Jack Nicholson movie. It's really a pretty good deal. And it helps us all, these are our friends, relatives and neighbors that need these services. We're all in this together. A child that's been properly treated, appropriately accommodated at school, and had the necessary social support applied will grow up to be a tax-paying citizen instead of the homeless guy on the corner, getting bucks so he can self-medicate at the liquor store. Speech over.