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And now what did you do TODAY?


morphsci

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Feeling much better today. Just 24 hours on the antibiotic cleaned up the ear infection quite nicely. Still a little sore but not full of fluid anymore and I can stand up straight, which is always nice.

Leftover cough, probably will last a couple days. Benefit though is that I'm currently 48 hours without a cigarette and going for the 72 that I've always heard will get me past the withdrawal. I'll probably smoke next week but I won't be at the point of needing to constantly feed the habit.

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Antonio, I'm on Pradaxa. Hopefully I can get off of it after a couple of months. It's much better than Warfarin as one doesn't have to check one's Protime very often.

Sounds great. Pradaxa use has been approved in EU a couple of years ago, so it's not being used around here much yet, where the most used anticoagulant is Sintrom (acenocumarol, a warfarin-like drug). I had heard good comments about Pradaxa, yours adds to them, so I wish more patients start using it over here. You don't know how hard it's managing a severe epistaxis (nosebleed) on a patient taking anticoagulants :palm:

I wish it goes well and you can stop using it.

Glad for your recovery NWT. Quit smoking, is the best investment on your health you can make.

Edited by Torpedo
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I discovered the worst use of a shot glass ever - hydrogen peroxide bath for still infected finger. Imagine 100 tiny needles attacking the tip of your finger for 10 minutes, that's about right. Good news is that the pain level today hasn't required the use of oxycodone or anything so far, the only lingering pain is from the persistent infection which will hopefully clear up over the weekend or more aggressive treatment may be required.

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^

Sympathies, Nate -- I'd probably pass out.

I'm man enough to admit that I came pretty close to doing so when they did the procedure and again today during the poking and prodding phase (no numbing agent for this???). My doc had the balls to say, "you're pretty sensitive." I felt like smacking him and saying, "No, two days ago you yanked my nail off and today you're literally poking the wound with a stick. WTF do you expect me to do, smile?"

I'd post a picture except when this is all over I want to purge all memory of it.

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I'm man enough to admit that I came pretty close to doing so when they did the procedure and again today during the poking and prodding phase (no numbing agent for this???). My doc had the balls to say, "you're pretty sensitive." I felt like smacking him and saying, "No, two days ago you yanked my nail off and today you're literally poking the wound with a stick. WTF do you expect me to do, smile?"

I'd post a picture except when this is all over I want to purge all memory of it.

I know how you feel (honestly) when I was about 13 I had my pinky finger crushed (like mince meat) between to large rocks. It also broke the nearby finger as well to give you an idea of the force. I then went into a reconstructive surgery where I did the first half or so with no real anesthetic because (through my mom) I have a natural immunity to anesthetic (took two more shots before it worked).

That said my mom had major surgery without it ever working...

Edited by Dreadhead
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Just read about the infection Nate, ouch, that sucks! I have psoriasis on my big toenail which basically makes it hurt anytime something is touching on it... I have more than once thought of asking to have the nail removed... but maybe that is not such a great idea after all.

@Matt: Hope you get better soon.

Edited by shellylh
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I have psoriasis on my big toenail which basically makes it hurt anytime something is touching on it... I have more than once thought of asking to have the nail removed... but maybe that is not such a great idea after all.

@Matt: Hope you get better soon.

Thanks Shelly. I'd say get that thing removed. A couple days of moderate pain is better in the long run than constant pain. Toes are better than fingers in that you can wrap them up and leave them alone a lot easier. If my pinky was bandaged I'd still find myself messing with it constantly. Just be prepared to keep your foot propped up for a couple days and you'll be fine.

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Just got hired to take photos of an underground hip hop show, all last-minute like. It's in my home town, so travel isn't an issue. That said, the two times I have been threatened by paranoid audience members for taking photos were both at hip hop shows. Some day I am going to pen Correia's Law of Perceived Lens Field of View: When the subjects wants to be photographed, every lens is extremely narrow and all subjects won't be in frame unless they're clunking heads and staring down the center of the lens. Conversely, if the subject doesn't wish to be photographed, every lens is a superwide and captures everyone in front of it in-frame and in-focus. :palm:

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I don't pretend to be an expert at all in this, nor do I play one on TV, but wouldn't a cytochrome p450 2d6 deficiency cause one to not really respond to opiate based anesthetics?

Yes, a certain percentage of the population (about 8-12%, I believe, and could be more or less depending of ethnicity) can be slow or fast metabolizers based on several of the cytochrome P450 isoenzymes, and 2D6 is the isoenzyme related to the narcotics. But a 2D6 deficiency would make one a slow metabolizer of medications metabolized by the 2D6 system, and therefore overly sensitive to those meds, whereas a 2D6 overactivity would make one a fast metabolizer and therefore under sensitive, since the medication is metabolized, inactivated, and excreted very quickly. Depending on how fast a metabolizer one is, that person may need much higher doses of that med, or it can be completely ineffective. There are lab tests becoming available now which test for this, but they're not so widespread yet.

A lot of psychiatric meds are metabolized by this system, so it's becoming a hot topic in my field.

Edit: I should add that this is purely related to genetics, what you are born with. You can also rev up your liver enzyme system through environmental factors, for example, drinking a lot of alcohol. But we'd know nothing about that around here ... ;)

Edited by jvlgato
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Skullguise, good luck on the job!

Yes, a certain percentage of the population (about 8-12%, I believe, and could be more or less depending of ethnicity) can be slow or fast metabolizers based on several of the cytochrome P450 isoenzymes, and 2D6 is the isoenzyme related to the narcotics. But a 2D6 deficiency would make one a slow metabolizer of medications metabolized by the 2D6 system, and therefore overly sensitive to those meds, whereas a 2D6 overactivity would make one a fast metabolizer and therefore under sensitive, since the medication is metabolized, inactivated, and excreted very quickly. Depending on how fast a metabolizer one is, that person may need much higher doses of that med, or it can be completely ineffective. There are lab tests becoming available now which test for this, but they're not so widespread yet.

A lot of psychiatric meds are metabolized by this system, so it's becoming a hot topic in my field.

Edit: I should add that this is purely related to genetics, what you are born with. You can also rev up your liver enzyme system through environmental factors, for example, drinking a lot of alcohol. But we'd know nothing about that around here ... ;)

This is very interesting to me. Do you have links to studies I can access?

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Finished another sour week at my increasingly sour job. Good part was that I spent the whole day with my son yesterday and we frolicked in the snow and all that stuff. I realize that those days are fleeting and precious, so I'm thankful for it.

That is SO much what it's all about! I was laid off in late 02/early 03 (on the books thru Jan), and for several months was able to work part time and spend a LOT of QT with my son. Some of the best days ever.

I know the "sourness" well; that (and that's being VERY mild) is why I'm interviewing now.

The good news is that the company told the recruiter they want me! It's a contract to perm situation, but I'm confident that I would convert if it's what I want. I need to negotiate first, though: either push for perm now, or push for a better hourly rate and pre-negotiate a salary if I do convert....

Exciting stuff!

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Sorry about sour work weeks! I totally get the fleeting joy of kids' stages. I am just counting the days before mine don't want to be with me and hate being hugged!

Vicki,

IMHO, this is a huge topic for us in the near future. It's a little bit of a fringe thing right now, but I've gotten a lot of people better after multiple previous failures, based on this principle.You know that 10% of patients who just don't respond to meds, or who can't look at a med without having profound side effects? (Maybe for you, it's the one who can drink or shoot up 10 times more than anyone else on the planet!) I suspect a bunch of them are the outliers in how they metabolize their meds. Right now I rely on asking a lot of questions, then trial and error. There are blood tests for this, but they're really hard to access, and expensive, and often not covered by insurance. Bah!

You can do a Medlit Search, term pharmacogenomics:

(I just did Google here)

http://www.ornl.gov/sci/techresources/Human_Genome/medicine/pharma.shtml

http://www.ncbi.nlm.nih.gov/pubmed/17269892

http://www.amazon.com/Psychiatric-Pharmacogenomics-David-Mrazek-MD/dp/0195367294/ref=sr_1_1?ie=UTF8&s=books&qid=1296305889&sr=8-1-spell

http://www.amazon.com/Pharmacogenomics-Discovery-Development-Methods-Molecular/dp/1617378259/ref=sr_1_2?ie=UTF8&s=books&qid=1296305954&sr=8-2-spell

http://www.ncbi.nlm.nih.gov/About/primer/pharm.html

Edited by jvlgato
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Good luck on the job, Todd!

Nate, jebus, I hope your nail/finger heals quickly. I'm wincing in pain just reading it.

As for me, finally got around to shoveling out a path for our mailman so we can get our mails again. I didn't have time to do it on Thursday morning before I needed to leave for work and then I was too tired to care the last two days after I got home from work. Now my stupid left wrist/thumb/fingers are yelling at me for doing manual labor - I really hope my the appointment on Wednesday can figure out what's wrong with them.

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