Apytele

Water aerobics and yoga are usually the best options. I would try to find a yoga instructor skilled in physical therapy / disability modifications to the poses. Water aerobics is typically specifically designed for physical rehab so you're more likely to find most of those classes are geared towards that. If affordability is a problem you may find that your health insurance, even or possibly even especially if it's public health insurance. In the gym though you want anything that's low impact and low intensity like maybe an elliptical on the very lowest resistance setting.

Relying on emergency services only wastes soooooo much money. Waiting until problems are acute and they HAVE to be treated under EMTALA means doing way more expensive treatments and clogs up emergency services. Not to mention that not vaccinating or treating bacterial infections results in a bunch of cooties getting spread around the community. And when they're getting those emergency services they can't pay for them so the cost has to get absorbed into the bills of the patients who can pay either directly or through insurance.

"I don't wanna pay for other people's Healthcare!"

You already are, just in the least efficient and most expensive way possible.

I went into nursing instead of astrophysics. Decided I wanted a job that would outlast the apocalypse.

Fun fact I learned waaay too late in my nursing career: if a patient has lost or damaged their amplifying hearing aid, you can put a stethoscope in their ears and talk into the bell.

None of you will ever use this but I share it with everyone now because it's really neat and I wish I knew it 10 years ago.

Eeeeh. I kinda get why it fell out of favor. For context, the weird thing about the nursing perspective vs the MD perspective is that you don't get as much of the benefit of large studies, but you also aren't as sensitive to big pharma marketing studies either which... good AND bad. Like for school I had to take a class on evaluating the validity of drug trials and one of the studies mentioned was taking advantage of the fact that there's basically no equivalent doses between different antipsychotics but you can also look at the doses from an experienced clinician perspective and be like huh they're saying this drug has less side effects compared to 20mg of Haldol daily, but literally ANYTHING has less side effects than 20mg of Haldol daily; that dose is insane. The nursing perspective also tends to be more sensitive to variations in the needs of local populations, you've lived in an area and worked within that specific demographic and environmental setting for a few decades vs the doctors main body of knowledge often even includes studies from across the world. Just giving some background as to the upsides and downsides of my perspective.

So back to my point, I can tell you I associate lithium with being a last resort med for really sick patients who nothing else cuts it for. I associate it with horrible side effects including crazy weight gain and thyroid problems as well as fluid and electrolyte balances, and depakote and tegretol aren't gonna cause that last one at all and also do have that advantage of blood level monitoring. I don't see tegretol prescribed as much but depakote is probably what I see as the most prescribed med even before lamictal. Now lamictal I completely understand why I'm not seeing in the inpatient setting; you can't rapidly titrate without risking the death rash (SJS/TENS), and the objective of inpatient care is always rapid stabilization with tweaking to occur in the community. And also maybe I'm associating lithium with all these horrible side effects because I'm seeing it used for patients suffering from both the direct effects of severe mania, especially those with the cumulative effect of multiple manic episodes over time, as well as all the other horrible things those episodes put them at risk of such as homelessness, substance abuse, and general increased risk of injury and illness due to decreased capacity for self care.

I guess the TLDR is, it wouldn't shock me if the inability to patent salt was the reason lithium isn't preferred, but I also associate it with being a pretty old-school heavy hitter like thorazine is for psychosis, and while my perspective has the advantage of being more experiential, that comes at the disadvantage of being less empirical (but its also often difficult to tell how empirical some studies are due to the influence of capitalism on the development of pharmaceuticals).

As a professional I'd basically be required to say the above, but I'm also watching from the inside as my country's health system decays starting with populations that were underserved to begin with like the mentally ill. In other news I have a hospice interview tomorrow. If nothing else I'll just get to focus on making people comfortable. That sounds so relaxing. I'm getting tired of having to tell people no all the time.

Just figured out what I'm getting him for Christmas, thank you!

Well its mixed because he still wants to be able to force his mistresses to get them. He just wants the poor to keep reproducing at uncontrollable rates because the best way to have parents not care that you're having sex with their children is to make sure they have too many to keep track of.