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The boring life of Jerod Poore, Crazymeds' Chief Citizen Medical Expert.

More Scheduled Downtime

Tech support at the domain host need to tweak the replaced disk array a little bit. We scheduled Tuesday, 10:00 AM Mountain time (1700 GMT) for that to happen. They expect it to take no longer than 15-20 minutes. As it involves hardware the entire site will be off the air.

We're back up, but who knows what things are going to be like.

Well, wasn't that special. When I restored everything to Sunday night's backup it turned everything back online. Which makes sense, because that was the status at the time of the backup.

I hope it everything works. Especially since I was restoring the fucking database, then converting it to a new format.

And Now We're Gone Once More

And the forum is offline again, because way too much is broken. Looks like I need to rerun the install. We may lose whatever was posted between midnight Sunday and now.

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OK, I'm testing the board software. Smilies are fucked-up. Not that I care.

And all posts, PMs, blog entries, etc. that happened after midnight Sunday are gone. Sorry.

We're Sorta Back

The good news: the forum is back online.

The bad news: the blogs aren't.

I'll try again tomorrow with the blogs, although it may require tech support, which means Tuesday at the earliest.

I haven't tested everything, so I have no idea what works, what doesn't, what has and hasn't been fixed or broken. Guess we'll all find out together.

Forum Software Upgrade has Begun

I don't expect this to take too long, as in two hours or so. We'll see. Check in around 2:00 PM Mountain time (2100 GMT).

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OK, make that 3:00 PM Mountain time (2200 GMT). I thought I had already uploaded the software to a holding directory on the server. I didn't. Hence the extra hour.

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This is what I get for writing an optimistic target time. Apparently the tag conversion process takes a long time. The more tags (over 1,100) and more blog entries (nearly 4,000) there are the longer it takes. So this could go on for quite some time.

Reminder: Forum Software Upgrade

I still plan on updating the forum software tomorrow. Beginning whenever I finish amusing the cats, eating breakfast, and finishing the crossword puzzle. So, figure noonish Mountain Time (1900, or thereabouts, GMT). I expect to be finished within a couple hours. Give or take.

For everyone else who shares my "It's just another day with an anomalous TV schedule" attitude, the only Xmas songs you'll ever need:


And We're Back

It took until around 1:00 AM Mountain Time (0800 GMT) to finish rebuilding the array and repair the forum's database. It's up and running now.

This is why I love Lunarpages. I know from my experience back in the Big Iron Age that resynchronizing the data on a RAID after a hardware fault and rebuilding a large database can happen only so fast, but there was someone there until midnight Pacific time making sure it happened.

We're off the air again.

Of course I don't check the site before doing anything, so I was unaware that we were getting an internal server error all over the place. I'll keep everyone posted.

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Update 14:41 Mountain Time (21:41 GMT): There's a hardware fault, and Lunar Pages tech support is looking at it.

In a way this is (削除) partially (削除ここまで) mostly my fault, as I had seen messages relating to the fault in one of the RAID drives starting a few days ago, but my social anxiety/avoidance was so fucking bad I couldn't even open a ticket about it. I kept trying to, but just couldn't.

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Update 16:45 Mountain Time (23:45 GMT): The drug pages, etc. are back up. The forum is still down, this time it's unhappy about the database. The new components of the RAID are still being synchronized, and nothing is obvious when looking at the database, so it might be a matter of waiting.
The Lunar Pages techs had the hardware replaced in about one hour. Pretty damn good for the Friday before Xmas.

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For anyone who is wondering and speaks *nix, here are the messages I was getting with increasing frequency for the last week:

Dec 22 16:17:02 server smartd[18984]: Device: /dev/sda, not capable of SMART self-check
Dec 22 16:17:02 server smartd[18984]: Device: /dev/sda, failed to read SMART Attribute Data

That's why I wrote it was my fucking fault this happened.
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Slight Redesign

With all the traffic coming in from Crazy Meds itself, I figured I should change the focus of the blogrolls to something more in line with the Crazy Meds site. Hence all the pharmacology, brain, and assorted medical blogs are now first, followed by links to similarly-themed sites that aren't blogs, then emergency room/department blogs, then the panoply, other blogrolls, and links to other sites. I also added a shitload of blogs to the neuro-pharma-med roll.

There is also another Facebook page, just for site content and status updates.

I should have known better

Just because I'm less susceptible to mood swings doesn't mean they won't happen. I wind up getting depressed and being unable to deal with my life. Oh well. It's been over couple years since I was last depressed, and that's the longest since I've been on meds. As part of distracting myself and convincing myself that I'm doing something I did a huge reorg of the blogrolls. I've pruned dead links, moved defunct blogs, added a shitload of new blogs to the Panoply, and added a new section dedicated to Emergency Rooms/Departments. Now you don't have to just take my word for it, you really don't want to go to the ER unless you absolutely must need to.

Who knows when I'll do all the stuff that needs to be done.

With Whom Does One Talk About Total Social Avoidance?

How bad has my social anxiety/phobia/avoidance been? By the time I've written and addressed 3-to-5 Christmas cards I'm emotionally exhausted, so that appears to be my daily limit. I'll be lucky to get all of them sent by the end of this week. The mailman just stopped by to drop off a package. That's the sort of thing that throws off my entire day.
Answering e-mail is out of the question. Posting this on my Crazy Meds blog or the Crazy Meds facebook page isn't happening either, as too many people would see it.

Like a lot of people I want more, because I can never get enough of what I already have. I want more latitude, altitude, and solitude. Living at 47° north has been good for me. 16 hours of daylight with long dawns and dusks in the summer, and 8 hours in the winter with the sunlight filtered by trees most of the day has made me less susceptible to seasonal mood swings. I'd like to live further north and higher up to enjoy things like auroae and noctilucent clouds more often. I'd really like a place at or above 53° north and 3,500 feet up, with a clear view of either the eastern or western horizon. Someplace to set up a telescope to look at anything interesting that comes by, like another green comet, and a receiver to listen to the solar wind.

As if any of that will ever happen.

If I manage to get the resources to leave this lemon of a glorified Unabomber shack I have to use them to move closer to a city with better doctors. It's becoming more difficult for me to drive, cook, and generally deal with my life. I need to live where I can take a cab to wherever I need to go, and get food delivered that's safe for me to eat. Solitude is no longer an option. Which sucks, because one of the few good things about this place is its location. Depending on where you center it, the population density here is between 1 and 5 people per square mile. When I lived in Berkeley and Missoula I often felt lonely. Out here I rarely do, and when I do it's not as bad.

I'm Popular! Why?

Anyone who knows me knows I'm a total stats whore. Whenever I'm feeling a bit off I look at statistics. Mainly Crazy Meds' traffic.
Starting 28 November there was a spike in the number of visitors. That happens. For some reason on 8 November the whole world did a search on Lexapro. Traffic has been continuously high since 28 Nov. - 10k-12k visitors a day. Not that I'm complaining. So I dug down to find out why. A big chunk of that is due to people visiting the page on TCAs. Directly. Not from other sites, not from search engines, not even from clicking on an link in an e-mail, but from pasting the URL into their browser from another source. The peak was 9 & 10 December, when over 3,400 people stopped by to look at that page. On 8 December 1,700 people went there directly, on 7 December 900 did.

The thing is, they stay on the page for ten seconds, if that. Hardly anyone goes to another page.

What the fuck is the attraction?

Most of the visitors are from major North American cities, but plenty of them are from Paris, Sydney, Dubai, Hyderabad and so forth. Of the places with more than 20 visitors, the people of Istanbul read the most on the site (78 visitors averaging 2.18 pages), and the people of Valencia stayed stayed the longest (39 visitors, average visit 3:54). Contrast that with the 12 cities where the average time for their 21 to 30 visitors was so short it couldn't be measured - they must have serious connectivity problems in Spokane, Duluth, and Puyallup - and obviously didn't go to any other pages.

Some of you may understand how I can read so many studies without my eyes glazing over. I may have lost the math to fully understand the more complicated stats, but I still like looking at the raw data.

They aren't printing the page. At least they aren't using the print function from AddThis. Have I done someone's homework, or is there something hilarious that I'm missing? Because I don't care how ridiculously stupid something I wrote looks. As long as the information isn't wrong and it helps people understand and/or remember something they otherwise wouldn't, I'll be happy to duplicate it elsewhere.

At some point the interest will probably die off, although site traffic overall is still over 9K on weekdays without the TCA page.

Abilify Page, Updates, More Cites, and I'm Sure it's Just a Coincidence

At long last, a brand new med page. Abilify. It may not be a new med, but at least it's a med that's being advertised. I'm still working on various pages, but the Basic Overview Page is mostly done.

I've finally added links to sites with consumer reviews. Most of the ratings/reviews are from the Big Five rating sites: Ask a patient Revolution Health Patients like me WebMD Drugs.com
I have links for these meds:

Crazy Meds was mentioned in another journal back in February, although it's in an article I'd file under "blame teh InterWebs.". From Psychotropics Without Borders: Ethics and Legal Implications of Internet-Based Access to Psychiatric Medications
Internet-based consumers have access to extensive medication information through websites such as erowid.com, crazymeds.com, and drugs.com, among many others.
That is one broad spectrum.

We also turned up as a source here, but it was one of those incidents when we seemed to be the only place someone could find the MADRS at the time. It wasn't the first time we were the only available source for one of the psych tests.

In a Zyprexa vs. Abilify study I found I learned that "which sucks less" has an official name - "time to all-cause discontinuation" - and that they run trials just to measure that. Whichever med has a longer time to all-cause discontinuation is the one that sucks less.
What's funny is when you run a search on PubMed and Google Scholar, the terms "all-cause discontinuation" and "all-cause medication discontinuation" are used in papers exclusively about psychiatric medications, and that comparative studies about how long people stay meds based upon which sucks less don't start appearing until 2005. Prior to then the term appears in a single paper about beta blockers and heart attacks, and then it was just to indicate that all the reasons for discontinuing are all lumped together.
It has to be just a coincidence that researchers didn't start doing studies comparing psych meds - using the fancy new term or not - to find out nothing more than which one sucked less (or the least) until over a year after I started a somewhat popular site about psych meds that used data from published studies, along with anecdotal evidence I collected and consumer ratings & reviews, to determine which ones sucks less than others.

Brand vs. Generic page. Finally.

At long last the Brand vs. Generic meds page has been renovated and updated.
As I come across them, I'll add URLs for case reports, studies, etc. that support one side of the issue or the other.

We're in PubMed, Bitches!

Of course the journal is Journal of Medical Internet Research and the article is mostly about consumers bitching about side effects online, but, hey, there we are, going head-to-head with WebMD once again.

Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet

Crazy Meds and Ask a Patient vs. WebMD and former consumer-generated media site Revolution Health on the effects of Lexapro and Seroquel. The results:
Consumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information.
The data are clear: WebMD can suck it.

The paper raises two points I constantly reiterate:
1 - Consumer-oriented sites, including this forum, skew negative, which is why I don't depend solely on them for the anecdotal evidence I use in my drug pages.
2 - Like drug company-sponsored studies, (削除) drug company-sponsored (削除ここまで) professionally-run sites tend to skew positive, which is one reason why I think they are still useful.

You have to really read the article to realize Crazy Meds and Ask a Patient are not total bitchfests about meds, especially since significantly more people taking each med reported they worked better on the consumer-oriented sites than on the professionally-run sites. I may have to re-evaluate how the stats skew.

Oh, NOW You're Crazy

Brent Arthur Wilson decided that he's crazy after all. The Montana Supreme Court disagreed. From the Missoulian:
Brent Arthur Wilson, who insisted on serving as his own lawyer dozens of times during court appearances last year and once threatened to "arrest (the) bond and seize (the) surety" of any attorney who said one word on his behalf, argued on appeal that he never should have been allowed to represent himself.
The court disagreed, and also ruled against Wilson on two other issues.
"Though we acknowledge that Wilson's demeanor with the District Court was unconventional and at times somewhat bizarre, the fact remains that he was found by a mental health evaluator to be mentally capable of making decisions and fit to proceed and act on his own behalf," Justice Patricia Cotter wrote in the decision.
"Mindful of Wilson's right to represent himself if capable of doing so, the District Court was placed in the difficult position of balancing Wilson's constitutional right to counsel with his right to represent himself," she went on. "We conclude the District Court did everything in its power to persuade Wilson to accept counsel, without unduly pressuring him to do so in possible violation of his right to represent himself."
Plus there was this bit during his trial:
"For the record, on the record, let the record show I have no constitutional rights, I want no constitutional rights, I claim no constitutional rights," Wilson said repeatedly during court proceedings.
Be careful of what you wish for and all of that.

Mug Discount & New Bumper Stickers

Zazzle is offering a 30% discount on mugs today (10 November) only, until 11:59 pm Pacific time. In honor of Veterans' Day, which is tomorrow. Enter code:
VETERANSALE4
at checkout in the "Zazzle Coupons/Gift Certificates" box. More details here.
Crazy Meds mugs are here. You're welcome for all the notice.

I've also put up a bunch of new bumper stickers, which you may or may not be able to see when you read this. A whole bunch of Team stickers: Agoraphobia / Anxiety / Bipolar / Crazy / Depression / Epilepsy / Manic! / OCD OCD OCD OCD / Panic! / PTSD / Schizophrenia. As well as: I Feel Fantastic!, My Doctor Can Beat Up Your Doctor, and My Shrink Can Beat Up Your Shrink. All of which are available as mugs and t-shirts.
Also new is a Team Crazy Meds mug, which I've also done with a solid black background. But it's not a completely black mug. Let me know what you think.

I got a My Shrink Can Beat Up Your Shrink and a Medicine Is The Best Medicine mug for my doctor. I'm impressed by Zazzle's print quality. The imprints on the pills are really clear. I have no idea how well they will hold up to dishwashers, microwaving, etc. But fresh out of the box the 'art work' looks really sharp.

Crazy Meds Mugs & Bumper Stickers Now Available

The annex to Straitjacket T-shirts is now open at Zazzle. Right now it's all mugs and bumper stickers. Some have the same designs you'll find on shirts, and some designs that may show up on shirts eventually, and some have their own designs.
A few examples manage to not look like utter crap as they scroll by:
[埋込みオブジェクト:http://www.zazzle.com/utl/getpanel?tl=My%20Zazzle%20Panel&at=238814449547090853&cn=238814449547090853&st=date_created]

So get your favorite medication prescriber a gift to show your appreciation, and let them know that someone besides their local pharm reps is thinking about them.

As much as I've complained about Cafe Press' gods-awful interface, Zazzle's is just as confusing, frustrating, and time consuming, albeit in different ways, such as being really fucking obstinate about orienting the mugs. I either want the handle on the left or in the back. Notice how many handles are on the right. And it handles alphabetical order as well as I did in 2003.

Plus at 14ドル for their least expensive mug, or 1ドル more than the cheapest t-shirt I offer on Cafe Press, I may wind up splitting the merchandise between the two shops or something. Fuck if I know. It's going to be a big pain in the ass no matter what I do, so figuring out which option sucks less is going to take time.

Occupy Big Pharma - or at least wear a t-shirt to tell other people to do so.

New Shirts at Straitjacket T-Shirts:

Occupy Big Pharma
Occupy Big Pharma
Big Pharma puts profits before people. Let everyone know you want to do something about it. Or at least tell people what you think they should do about it.
Fuck Big Pharma!
Fuck Big Pharma!
If Big Pharma really pisses you off, let everyone know about it.
Big Pharma Sucks!
Big Pharma Sucks!
Or you can wear one of these if "F#¢< Big Pharma!" isn't really your style.
Occupy Sanity
Occupy Sanity
It's political AND a cry for help.




Team Crazymeds
Team Crazymeds
And I want you to be able to advertise my site in as many ways as I can think of.
I've just opened a store on Zazzle for non-shirt items like mugs and bumper stickers. I'm working on those. I'll probably move the shirts there eventually.

Why I Hate Mythbusters

  1. First and foremost: fewer myths (urban and otherwise) and too many ads for movies disguised as episodes debunking Hollywood physics. Especially when they do James Bond, because it's product placement within product placement.
  2. While I like explosions as much as the next person, not every episode needs to be about blowing things up. The Discovery Channel is the "Watch People Blowing Up Stuff Because That's Their Job" network, so they could have an entire show dedicated to great explosions and blowing stuff up. "Tonight on The Biggest Bangs we'll be making detcord macrame, comparing the different properties of explosions produced by vehicles powered by regular, diesel, natural gas, and other fuels, and taking a look back at the 1947 Texas City explosion."
  3. Padding. My memory sucks, but is a detailed review of what happened prior to the commercial break really necessary?
  4. This one might actually bother me the most: wasting all of that food. Granted that is a quintessentially American thing to do, but when I see the last 10 minutes of a Mythbusters episode before whatever I want to watch on the Science Channel is on (e.g. (削除) In Search Of... (削除ここまで) Dark Matters) and they're blowing up or otherwise destroying a shitload of food you know what's going to happen? That's right, there's going to be an ad about starving children that makes you sadder than watching an hour-long infomercial of Sarah McLachlan in puppy Auschwitz.
    No wonder people who live in countries where they like to keep women uneducated and at home all day so they have at least eleven kids hate us. They're starving and we blow up food for entertainment purposes.

Away we go

I've begun the forum and blog software updates.

I have no idea how long this will take.

It's about 11:15 Mountain Time (17:15 GMT) and the files are still being uploaded to the server. This is a big-ass update, with over 3,000 files totaling about 31 MB.

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Update: It's now 1:15 PM Mountain Time (19:15 GMT). The file upload is finished and I'm now starting the install.

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Update: A little after 3:00 PM Mountain Time (21:00 GMT). The upgrade is complete, and I'm going through some settings.

I may have fucked up the avatars. The new version allows only one picture per account instead of two. I thought I told the upgrade process to use everyone's avatar as the picture, but I'm not sure it did that. Invision's syntax is often counter-intuitive, to me at least.

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Update: As of 4:10 PM Mountain Time (22:10 GMT) the Crazy Meds forum is back on the air.
I can't tell you how much I hate the new look.
Allegedly the old version of the default skin is available, but it doesn't work. I'll see what I can do.
At least the avatars don't seem to be as fucked up as I thought.

Now 25% Less of a Crazy Cat Person

One of my cats is missing, and presumed eaten. I don't know how long he's been gone, because he vanished around when I got really sick, and I don't know when that started or how long it lasted. I also don't remember if he was gone before I got sick, or if that happened while I was ill. I've never had a physical illness fuck with my memory like this.

In addition to being barely able to take care of myself and the other three that managed to stay, I wasn't concerned because one of his sisters is in the habit of going away for a few days, even a couple weeks, now and then. They are both really good hunters, and catch (and eat) hefty game like squirrels, wood rats, and decent-sized birds like robins. This time of year they'll catch at least one critter a day. They are both extremely shy, so putting up lost cat posters, notices on Craigslist (which gets maybe one hit a year from this neck of the woods) wouldn't do much good.

Then MAO went missing. And the porch was covered with the spray of a large predator. And MAO's remaining two offspring were acting really weird. I wasn't very functional that day. Fortunately I found her, 20 feet up a tree. She wasn't coming down. I dragged a ladder on top of the carport, fought the vertigo of standing on that (ladders and I don't get along) to hold out an eight-foot-long plank to a branch below the one she was on, and she wouldn't step on to that fucking thing to walk down to me. Eventually I had to give up. I was physically exhausted from repeatedly putting the ladder on the roof of my truck, climbing up onto the carport, pulling the ladder up onto the carport, trying various things, putting the ladder back on the truck, climbing down, getting more stuff, climbing back up, lather, rinse, repeat.

I figure, she's a cat. She'll get down when she's ready. The tree has a shitload of branches that are fairly close to each other, and stands between a carport with a flat roof and a garage with an A-frame roof. I left the ladder on the roof of the truck so she could get all the way to the ground. Karuna got down from the now-cut-down eucalyptus tree that was at my old place in Berkeley without any help. She was also about 20 feet up, and that tree had hardly any branches below her and the only thing near it was a fence.
Nope. MAO was still there the next morning.

I tried the plank again. Same thing.

Eventually it dawned on me. Falling out of a tree is probably how she broke her leg. No wonder she won't climb down.

So I started calling around, trying to find someone with a boom lift. Eventually I found a tree service in Missoula with someone available to come out right away. It cost 800,ドル but when you live on the outskirts of civilization, you have to expect that sort of thing. MAO was more than happy to be rescued by them.
I don't know if the local volunteer fire department still rescues cats from trees. I wasn't going to call them, or the utility company. Even if either of them did that sort of thing, with my luck as soon as they got here there would be an emergency somewhere else, and today I would still feel like it was my fault.

So now everyone stays inside at night. They aren't all that happy about it, but tough titty.

Forum software upgrade 18 September, 2011

I plan on updating to the latest and greatest versions of the forum & blog software Sunday, 18 September. All subject to the whims of health, physical and mental, and fate.

Most of the changes are behind-the-scenes sort of stuff, concerning things like performance, moderator tools, and system administration. Changes everyone will see include:
  • A new text editor, which I usually classify as "change is bad." Like this new blogger editor and interface. At least IPB's new editor comes with two useful features: autosave (finally!), and it will notify you if someone posts a reply before you finish with your reply.
  • You'll be able to add tags to topics. I can hardly wait to see some of those.
  • Following topics, being notified of new content, etc. is supposed to be easier to do and less buggy.
  • Liking stuff and social media interfaces are supposed to be easier.
  • The user control panel, where you play with your account settings and the like, is supposed to make sense and generally be easier to use.
  • Fixes for various bugs on the blogs and the mobile interface.

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