Critical care nurse here. The answer is esophageal varices.

It’s the same physiological anomaly as hemorrhoids, except in your esophagus. Swollen, fragile veins caused by increased internal pressure. In the case of hemorrhoids, that pressure inside the veins is caused by straining too much when trying to poo. In esophageal varices, the increased pressure inside the esophageal veins comes from blood backing up from a swollen, scarred, and damaged liver. So we often see esophageal varices in end stage alcohol use disorder.

Horror stories abound in emergency departments and ICUs of having to do CPR on a patient massively hemorrhaging out of their mouth from esophageal varices. As soon as nurses I know saw this report, our immediate thought was, “Yep, varices.”

https://my.clevelandclinic.org/health/diseases/15429-esophageal-varices

Just did. Won our vote Wednesday night 💪

GOP death cult be like, “Hear me out, do you really NEED to live though?”

To me, it’s all about rational return on investment providing economic incentives to achieve what we want to achieve.

My favorite example to explain what I mean is my own personal health insurance. I have a chronic medical condition that requires constant medication, frequent visits to specialists, and expensive medical tests and procedures. There is simply zero chance that I will ever pay enough in a monthly premium to cover what I cost. Meaning I am always a net financial loss for a private, for-profit insurance company.

This gives a private company every incentive in the world to obstruct and deny my care in hopes that I’ll get frustrated and give up, or maybe even die and get off their books forever.

The government, on the other hand, has a positive financial incentive to keep me healthy. If I am healthy, I am working, paying taxes, buying goods and services that contribute to the economy, and hopefully contributing something beneficial to my community. Only the government (acting as a proxy for “society”) naturally profits from insuring my healthcare.

This is why I believe we should have fully socialized medical care. Because there are some specific things that only the government has natural positive economic incentives that align with what is beneficial for the general public.

Whatever those things are, they should be socialized. And generally those things are basic life sustaining things like food, housing, medicine, education, utilities.

I’m fine with privatized capitalism in a very restricted, heavily regulated niche form. But all the basic necessities should be socialized.

This is the one they were waiting for. There are several live cams trained on the area, and one of them caught the exact moment it erupted:

https://youtu.be/QcxaqCIon_Y?si=oLk4o29hIaSrv4WF

Oh fuck off. You know damn well that 90% of society would raise an eyebrow at a 3 year old boy trudging around in high heels and getting into mom’s lipstick.

NO ONE TOLD HER SHE WAS TRANS. SHE SAID THAT.

What part of this was self-determined is hard for you to understand? Transition was 100% initiated and driven BY HER. It’s what she wanted because it’s what she understood herself to be inside her own mind.

Final Destination, Expanse style? That sounds… unpleasant lol

Huh, now that’s super interesting.

Ok you and I both have to go to sleep, but now you’ve got me wondering about the eternal debate amongst our medical residents about benzos vs. barbiturates for acute alcohol withdrawal. I’ll have to read up on this some more

Bathroom? Going out Elvis style

Nice username, fam! I’ve not found an Expanse community around here yet, but I see lots of fans

Oh you’re getting in the weeds now hahaha. Looks like it’s primarily GABA_A

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326685/

I just had to look that shit up haha. I’ve never thought to check into it beyond just “you’re not breathing, so I’m about to make you very angry by reversing your high, sorry bro” lol

So, it’s interesting, because it’s well-known to have effects on the same GABA receptors as benzodiazepines (like Xanax), but none of the addictive, physical dependence problems, and apigenin doesn’t respond consistently to the drug we use to reverse benzos (called flumazenil).

So… we’re not entirely sure? It could still be the GABA effects that help with sleep. But there’s also a host of antiinflammatory neurological effects that probably better explain its efficacy against Alzheimer’s, for example.

Now, if you really want to put yourself to sleep, feel free to crawl through this alphabet soup of a research article lol:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472148/

Here, I found a good article for you:

https://www.uspharmacist.com/article/assisting-seniors-with-insomnia-a-comprehensive-approach

Literally the only thing that gives me refreshing sleep. (See also: mitochondrial dysfunction that I mentioned in my other comment about CQ10.) Apigenin seems to improve what’s called “sleep architecture” in a way that none of the pharmaceuticals I’ve ever tried do.

Yeah, long QT syndrome is estimated around 1/2000 people. Relatively rare. I fully confess that I’m just traumatized by my personal experiences with patients taking the drug lol

Hahaha, I love working with older folks. They’re my favorite patients.

I actually WOULD recommend this for seniors. It does not have any anticholinergic side effects like a lot of pharmaceutical sedatives do, and it doesn’t interact with the most common blood pressure or cardiac meds that older folks often take.

I have the same problem with magnesium supplements. Mag glycinate has less of that laxative effect than mag citrate, so she could try that as well.

The only two caveats I would add are: she should definitely tell her doctors she’s taking it, as with any OTC supplement. And if she’s specifically on a drug called warfarin (Coumadin), she should be very cautious. (Even Tylenol can cause warfarin to build up in the body. Warfarin sucks, so we don’t use it as much anymore, but it’s not unheard of.)

Hope that helps! (I’m a cardiac nurse. I work with older folks a lot.)

Yep, that’s the usual recommended dose - 200mg like an hour before bedtime

Yeah, medically cyclic vomiting syndrome is usually more associated with cannabis abuse disorder, so you’re probably not going to get far trying to get that diagnosis specifically. But that doesn’t mean these same treatment regimens won’t help. Think of it as physical therapy for the gut and nervous system.

Oh man, you are really challenging my senior citizen brain here. I think I know how to bold things haha

I like Nootropics Depot as a source company. They sell it for $20 for a 30 count bottle of 200mg capsules.