He respects me a ton, would take my advice very seriously and likely keep it between us. He would probably slow things down and make his own choice, but there is a possibility it gets back to her and she blows up on me.
We all work together lol.
Super weird side development. I asked her how things were going with him and she freaked out on him. Apparently she wants to keep that separate from me and not have me know how things are going or that they’re involved… which makes no damn sense to me. I’ve made it clear I’m not interested in her.
I just really hope he doesn’t end up in a situation like me because it was miserable, but yeah I will go with my initial reaction and leave it be.
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It’s both weird and frustrating that some things that “work” feel like they may only exist in your mind and could potentially be more rooted in astrology than science. I think there’s a potentially plausible scientific theory (or group of theories) here though: Zoloft is (at least partially) metabolized by CYP3A4, as are very many drugs. CYP3A4 also metabolizes and is induced by cortisol which is diurnal and reaches peak plasma concentration in early morning, so maybe some mild interaction / modulation there. Circadian variation in metabolism is definitely something they consider in these drug interaction studies. See this brief review:
To study the effect of SJW on cytochrome P450 3A4 (CYP3A4) activity, these investigators measured levels of cortisol (which is metabolized by CYP3A4) in 13 healthy individuals taking standard doses of SJW (300 mg standardized to 0.3 percent hypericin, three times a day).
To control for the circadian variation of cortisol metabolism, investigators used the ratio of 24-hour excretion of urinary 6-β-hydroxycortisol to cortisol.
Of course, it may have absolutely nothing to do with this–there are probably a million different possible explanations. My point is that a real biochemical mechanism could explain why a timing change could work, and so maybe this one example can help you envision how something as mystical as “try taking the pill a few hours later” might actually be effective despite the exact x → y → z chain of causality being difficult to prove. IOW, there’s a class of explanations that would lead you to believe it might work.
Don’t get me wrong, I’m still skeptical, but the thing that bothers me the most is mysticism, and the only way I’ve found to bridge that gap is by reading a lot. I’m fine trying something my doctor advises as long as I can see some plausible theory, reasoning, or evidence as to why it might work, but you’re correct in that it does seem rather fickle and unpredictable when the tweak resembles an old world folk medicine idea such as timing your dose to a slightly different position of the sun. That is really unsettling as a patient.
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Pretty hard situation because you also can’t just go around telling people she’s threatened suicide, so probably mind your own business is right, but if he were like one of my very best friend for life kind of friends…well, I guess I would probably have already talked to him about it.
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I forgot to ask: do you have any grapefruit (or any fruit) juice in your diet at all?
Yeah my first thought was “JT seems like a grapefruit guy.” Since Zoloft goes through CYP3A4, I have to imagine there’s at least some interaction. Your pharmacist knows so I’d go with their answer, but I wonder if they’d clear grapefruit just on the grounds that Zoloft won’t do awful shit if 3A4 is inhibited. Because my idea is that, if you’re like me, you might go through periods of having or not having grapefruit in your diet while not consciously correlating that to apparent changes in the efficacy of the medicine.
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My mom officially stopped all medical intervention today and I feel relieved. Don’t know if that makes me a monster!
She seems at peace for the first time in weeks. It’s a matter of days or a week now.
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Oh I was saying in the post that I’d say vague stuff. Like he should try to really get to know her first and take it slow and that he needs to be careful.
I’d never tell him that kind of stuff.
Not a monster at all. Is want the same thing for my mom
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I hope you’re holding up ok. It’s a very hard time losing a parent.
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At a certain point, I think you just accept your death as a release. After that, you probably feel less anxiety about your fate.
I remember watching a family friend just get absolutely tortured by terminal cancer before finally dying. He could barely see, couldn’t hear and had difficulty speaking. His pain was so intense that even opioids couldn’t take the edge off.
Terrifies me just thinking about it.
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It’s so weird why we make people go through this but put our pets out of their misery. Makes no sense at all.
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When our pets die its very sad bit it doesn’t trigger the kind of existential dread that comes with watching a parent die. Alot of people have purely instinctive reactions to keep their parents going at all costs.
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I think this is a big part of it for sure.
The weirdest part is euthanasia is legal here but the hoops make it too hard to get at end of life. She can refuse medical care and even ask “for a pill to end it” but the former is easy the latter is still very difficult. So it is ok to let her fade away over days, drugged to the max, but not give one pill to end it even when it’s technically legal.
I assume it’s tied to ancient medical ideas of “do no harm”. @CaffeineNeeded is this the ethical idea?
It’s really hard on the physicians who are trained to heal. Some good stuff here:
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Hippocratic Oath is a bunch of bullshit. Not all medical schools even use it.
We really should update to oath to be more relevant, perhaps a maximum number of BMWs owned or something.
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There’s nothing wrong with being on the meds long term. I have accepted I will likely be on them the rest of my life. Every time I stop, or even start missing doses, it comes roaring back.
The meds haven’t cured me but they make life tolerable, and that’s all I need.
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I can put myself in his shoes. I didn’t mean to sound callous. It is just exasperating knowing that it’s totally possible for him to get out of this but he doesn’t want to. He literally doesn’t. My other friend recommended him a good therapist last night and all he said was “i’ve accepted my fate, nothing can cure me, if i die i die.”
He’s just gonna slowly kill himself with drinking I guess. Nothing I can really do about it at this point. It’s sad.
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