Notices by Hannu Ikonen, MD (hannu_ikonen@med-mastodon.com), page 2

Continued

If there *is* a shortage, my preference is to wait until the 90 day supply is available as piecemeal is complicated and requires multiple trips when I'm seeing patients.

It is also not a policy of our department - Psychiatry - that controlled substances are ONLY refilled with a scheduled follow-up. I filled 19 today and I don't see them for a couple of months. If that's a policy of the FM department, that's simply a barrier of care for the sake of there being a barrier to care.

Sources:
https://www.dea.gov/documents/2023/2023-10/2023-10-06/dea-and-hhs-extend-telemedicine-flexibilities-through-2024
https://chadd.org/advocacy-blog/chadds-position-on-patient-access-to-adhd-medications/

Sincerely, Hannu Ikonen, MD

Post-script:

My apologies if it sounds assertive but I've been in (Purple State), (Blue State), (Maroon Red State), and now back in (Purple State) and have not run into a single issue until becoming a patient in YOUR healthcare system. Ever. Not once. And it generally has not been because of the med shortage.

Hannu Ikonen, MD

Likud, Netanyahu can stop being ethnic cleansers at any point.

But this is who they are.

Israel is a pariah state at this point.

https://www.who.int/news/item/19-02-2024-children-s-lives-threatened-by-rising-malnutrition-in-the-gaza-strip#:~:text=The%20rate%20of%2015.6%20percent,three%20months%20is%20unprecedented%20globally.

No, the post-Citizens United open class warfare by the transnational wealthy isnt status quo; its definitely accelerated & more out in the open.

What is status quo is the post-Reagan/Thatcher fellow traveling have-your-cake-and-eat-it-too neoliberal response to it, complete w contempt & condescension toward the left & the vulnerable.

And that's whats so much more alarming.

Even the "liberal" SCOTUS members were being dicks about Colorado's well-reasoned disqualification.

Was obvious.

On to the next chapter.

I dont hate Mondays,

I hate a barely meaningful existence where safely having a family is taken away, freedoms are routinely pared back, & 88% of the people around me are pot committed to the fossil fuel death cult.

Oh, and capitalism.

It's fascinating that not enough people seemed to have learned the lessons from Jurassic Park that Samuel L. Jackson's character gave his life for:

Always have a default reset hardware option.

This Change Healthcare ransomware hostage-taking of thousands of pharmacies, and some hospital systems, is a wakeup call.

It should be fixable but instead we're all holding onto our butts and rerouting prescriptions all over the place now.

I am not an IT guy, but this strikes me as foolish.

"CDC Ditches Public Health" more accurate headline.

Just quickly - anyone here works for the #CDC or has "well respected buddies" there?

Fuck you. You and your buddies are Social Murderers.

https://en.m.wikipedia.org/wiki/Social_murder

Be a real ally & resign.

Bad Guys: "Theres a Third Way, where I sell them out and kiss rich white ass, and move the Overton Window to the right in a ratchet-like manner, only I do it less flagrantly and lock in the concessions made by the plebs."

Badder Guys: "Brilliant. Now, off to Epstein Island."

Friendly reminder / Current Campaign for #providers

Lamotrigine is great in bipolar depression prophylaxis, may help in acute bipolar *depression*, but has LITTLE TO NO antimanic properties & can make mania worse.

So, if a patient says their mood is labile or seem hypomanic and don't have anything but lamotrigine on board, consider adding an actual anti-manic such as lithium.

https://pubmed.ncbi.nlm.nih.gov/34489127/
https://pubmed.ncbi.nlm.nih.gov/34646439/
https://journals.lww.com/intclinpsychopharm/abstract/2022/11000/lamotrigine_induced_mania__warning_report_for_the.7.aspx

#MentalHealth #BipolarDisorder #Depression

Since mediocre white techbros are monetizing all of The Stupid on the internet, seems like a good time to backup important emails and delete everything else.

@aral This could be any number of countries at any number of junctures in history is the amusing part.

1870 Bismarckian Germany?

1849 counterrevolutionary suppression?

1933 Racial biasing of New Deal & Federal Grants?

DLC & Third Way autophagy since Reagan/Thatcher?

Yearly reminder to #MaskUp.

March 2020 an asshole private practice dick was trying to force me to see patients in person despite a history of clots, asthma, and pulmonary infarction just years earlier.

I refused, got an ADA excuse from my doctor.

Still "did my job."

Saw patients virtually without issue.

That attending was 43yo & went in.

He didnt live to see 44.

He died after #COVID19 & probable Covid-induced myocarditis.

Otherwise healthy before all that.

#WearaMask

Thousands of patients have missed out on care from that prematurely dead, talented doctor because of hierarchical rigidity and paradoxical selfishness of demanding a fake normalcy rather than accepting & responding to reality on reality's terms.

Thousands more have been able to get care from me because I defied the hierarchy.

While every situation is different, this was cut and dry: virtual was an option.

I took it.

He didnt, and tried to force me to unnecessarily risk my life.

OTOH maybe I'm obnoxious and you wish I died, fair enough have a good one.

[Edit: Dark Humor here thats all]

Can't imagine why "the average Western doctor in the community is 17 years out of date" when everything is paywalled & sci-hub keeps having to move around.

Genius idea Capitalists, *make it harder* for doctors to learn. Genius.

Nex Benedict was killed in a State-Sponsored slaying.

We seem to call that out when Iran does it, but not when U.S. states do.

enshittification just sent me on a 3 hr circlejerk that ended up right where I started and the process of trying to verify myself to get a new sim card or an e-sim...requires the aforementioned malfunctioning sim card...which is impossible...

So I annihilated a laptop and some drywall.

i want off this shitty ride of ai chatbots, laid off humans, & circular reasoning (read: broken) tech.