Akathesia is no big deal, right?

10mg Haldol Tablet

10mg Haldol Tablet

Let’s say you go into the emergency room, screaming in pain. You let the doctor know that there are drugs that will help you, but, unfortunately, like many pain drugs, they also are abused by some, so the ER doesn’t want to give you those drugs (another part of our war on drugs that has collateral damage – but heck, it’s only sick and disabled people, so who cares – we’re supposedly making a difference in drug addition, after all, and sacrificing the sick and disabled is worth that [yes, sarcasm]).

Then you make a mistake. You mention a past mental diagnosis – you know, something like autism. But it could have been any number of other labels – depression, anxiety, OCD, MPD, PTSD, etc. After all, you assume that they are asking all these medical questions of your past to help you, right? No, they’re trying to label you. And once crazy, always crazy. Even if complaining about something completely unrelated to crazy. Like pain.

But, with this new information, the ER staff says, “Oh, he’s crazy. That’s why he’s screaming. We need to calm him down.” NOT “we need to relieve his pain.”

Maybe they do some tests (more on that in a bit) on the off chance they are wrong. But while waiting for those results, let’s get the person to quit screaming. Now there are two ways of doing that: we can actually treat the complaint or we can do some other random shit. Treating the complaint is boring medicine. So let’s do random other shit.

Let’s say the person I’m describing above was given Haldol and told it was “for pain”. No, it was to sedate and shut him up. But crazy people don’t need to give consent, right? The result of this was a significant bought of akathesia – basically the person wanted to die right then and there. In other words, the Haldol made him crazy. But of course that’s not what that’s seen like – what it’s seen like is they need more sedation, not that they are having a bad reaction to Haldol (despite bad reactions being common – more on that later, too). Crazy people act crazy. It’s self evident. Oh, not just crazy. But also drug seeking probably because they are an abuser. Lots of crazy people are, after all.

And don’t even think about telling them it makes you react bad. The only reason you’ve been given Haldol is because you’re crazy, and just saying you don’t need or want it – or that it does bad shit to you – is proof you need it. Great, huh? Don’t believe me? Read M.D.O.D., which I quote:

If I read on the triage sheet that you are “allergic to haldol” I will duck and dodge and try not to see you. If someone has given you haldol you are either schizophrenic, in which case you need it or something like it and it’s really too bad you are allergic to it, OR, you are a freak, and one time when you were completely bat-shit crazy in the E.D. six people held you down and you got a nice intramuscular injection of this neuroleptic drug. You didn’t like it because it made you shut the fuck up and feel unpleasant hence you tell people you are allergic to it. No worries though, I’ve got more up my sleeve if you freak-out again. Lot’s more, but I’m not saying what so you can’t tell me you are “allergic” to it. Haldol, if you are crazy it makes you sane, if you are sane it makes you crazy. Beautiful.

Really, that’s a doctor posting something I think he thinks is funny and amusing. Clearly he hasn’t experienced the side-effects, nor does he see his patients as even remotely human. I wish this type of doctor was rare, but it’s not.

On those side-effects, read about one form of the drug. If you’re not willing to give someone a painkiller in the ER because of possible risk of bad things happening (contributing to drug abuse), why the heck would you give this, when you don’t have a patient relationship and the ability to monitor? Simple: They are crazy and you don’t give a fuck.

Of course that Haldol causes akathesia isn’t particularly new news. Here’s a 1984 study – yes, 30 years ago – 40% of patients experienced akathesia within 6 hours of a single dose. Within 7 days, 75% did. And it was severe – life threatening – akathesia in many cases. And for many people, NOTHING could treat the akathesia. Really about all you can do is sedate, wait for the drug to leave the bloodstream, and maybe restraint so they don’t act on their strong desire to die. That the doctor caused. The best quote in the abstract? “We believe these tallies to be important because akathisia causes much misery and often goes undiagnosed.”

But of course if you’re a hospital giving people Haldol and then walking them out the door, and the person kills themself a few hours later, that’s because they were crazy. You tried to help, after all.

I probably should take a minute and define akathesia. It’s life threatening – see this British Medical Journal case study (also drug induced, as are most cases of akathesia). Akathesia is hyper-arousal, typically also accompanied with severe restlessness and inability to sit still. This is seen as craziness of course. Unfortunately, much of the writing talks about akathesia being “uncomfortable”. It’s not uncomfortable. It’s life threatening. It can be the worst anxiety you’ve ever experienced. That’s not a comfortable thing – you just want it to stop.

Of course akathesia isn’t the only side effect of these drugs (and Haldol isn’t the only one, nor are newer drugs significantly different in side-effects, despite the best attempts of marketing to say otherwise).

Oh, the thing that they initially treated with Haldol? For the person I’m basing this article on – with many personal details changed – one of those “long shot” tests came back. Meningitis.

Haldol is not a treatment for meningitis. And the person’s symptoms were consistent with meningitis. But the Haldol nearly killed the person prior to getting proper treatment for meningitis. But until a supposed crazy person can prove their illness has nothing to do with being crazy, everything is because they are crazy. Everything. And they’re a drug seeker too.

The ADA, Obamacare, Health Insurance, and Job Killing

You know what the biggest threat to America is right now? The one thing that could push us into massive unemployment?

Apparently it’s healthy people.

20 years ago, it was disabled people. If you made every business build (with a corporate welfare subsidy in the form of tax breaks and tax credits) ramps and such for “those people”, then suddenly you’re going to close down every business. Yep, that happened.

Okay, no it didn’t. Now it’s a lot more common (but not common enough) to see disabled people work.

The next step for disabled people is universal coverage. Obamacare ain’t that. But it’s closer than we’ll be without it. A huge reason a lot of disabled people stay away from work is that they have complex health care needs – and most first jobs don’t provide insurance. I know there are all sorts of programs that, if you do them perfectly, will solve this, but at the end of the day people want assurance that their medical needs can be taken care of. Life is valued more than work. Go figure.

Of course most of the people who want to see Obamacare go down in flames aren’t dealing with that. They’re worried about “rationing” (in otherwords, if we treat the medical needs of everyone, then the better-off among us won’t get medical care, supposedly – of course there is no evidence that’s true, and usually the people talking rationing aren’t looking at whether or not everyone is getting care today; hint: we ration today, just on the basis of money). And they are worried about the possibility they might have to buy one birth control pill (because we apparently want abortion instead of pregnancy prevention so we can rant that we’re pro-life and any woman who has had sex but doesn’t want a kid is a slut who deserves punishment). And we’re worried about non-existant death panels.

Then they’re worried about job loss. People are going to have to lay off workers, they say.

Let me tell you something about most businesses: they don’t keep extra workers around for the hell of it. Most don’t run or operate as charities. They have exactly the number of workers they need to fill the demand for the product (or less). But they don’t have more. If they do, you know what they do? They do lay offs. Even successful businesses don’t provide guaranteed employment for life, if a position is no longer needed. And if that person is making the business more money than the business would make without them, they stay employed. After all, if you don’t have extra employees, getting rid of an employee means two things: overtime (which is typically even more expensive then the employee you got rid of) or not selling as much stuff as you would otherwise sell. And most businesses like selling stuff.

When a business owner talks about how his business is “already struggling” and that Obamacare will force layoffs by pushing him over the edge, ask why he hasn’t addressed the struggling business. Ask if he’s rehiring for positions after people leave. If he is, he doesn’t have more employees than he thinks he needs (you wouldn’t pay out money you don’t have to if you are struggling). But if he has plenty of employees to lay off on day one of an employer mandate, he’s badly managing a business and putting everyone’s jobs on the line with his poor management. This is particularly true if he’s not actively trying to shrink his current workforce – which can be seen by figuring out if he’s hiring new employees to replace ones that left.

If he is making money, then this is whining about not being able to pay as much of a less than livable wage anymore – he’s going to have to get closer to the point where his employees can afford to live.

But the simple fact is that employers don’t have extra employees. Maybe after Obamacare’s employer mandate goes into effect, we’ll see some employers lay people off. But I’ll give you a hint: that would have happened anyway, as they were not needed in the eyes of the leadership. It’s bad resource planning, by leadership – they purchased more manpower than they could afford or need. And Obamacare gives them a convenient excuse to use rather than just plain greed. Don’t let a bad manager get away with blaming Obama rather than taking responsibility.

Brockovich Syndrome

A recent Wall Street Journal article describes what happened as a result of Wakefield’s lies. In the name of “keeping kids safe”, parents are avoiding vaccines that are known to be both safe and effective, and which, ironically, really do keep kids safe.

I call it Brochovich Syndrome. Erin Brockovich, a non-scientist, single mother, uncovered a health disaster caused by the local utility near her small California town – the utility was poisoning the water and then lying about it.

This has caused countless others to search for the causes of things like autism. Many non-scientist parents blame vaccines for causing their child’s autism, either through the preservative (which contains mercury atoms) or the MMR for being too much for the child’s body at once. Some even combine these theories. A man named Andrew Wakefield, who had a serious, undisclosed conflict of interest proposed the MMR theory.

A diagram of a Thiomersal molocule.  See the gray thing?  That's where the Mercury atom is.

A diagram of a Thiomersal molocule. See the gray thing? That’s where the Mercury atom is.

Of course smart people – with actual medical training – came up with the idea to use preservatives in vaccines to prevent bacterial and fungal contamination of the vaccine. In essence, it’s not too different than asking medical professionals to decontaminate wounds with agents that kill bacteria – these infections can be deadly. Obviously, injecting live infectious bacterial or fungi into a body is a bad thing. So they added thiomersal (alternative name/spelling: thimerosal). They needed something that would kill fungi and bacteria, to keep vaccines safe. So they used this chemical to do it. Thiomersal technically includes mercury, although saying that is rather like saying “Water contains explosive hydrogen” because water has two hydrogen atoms and one oxygen atom. Thiomersal consists of, yes, mercury atoms, and also sulfer, sodium, hydrogen, and carbon. And while it is a toxic substance (so are lots of drugs we use – the key is dosage – when you want to kill disease, you use things that…well, kill – for instance, oxygen is toxic). So, a tiny amount of thiomersal is used, which has been determined to not be harmful to humans (even infants) in the concentration used, to avoid infection, which has been determined to be deadly to humans (even infants).

What happens when something like thiomersal is not used? Simple – people die. Of course if you think autism is worse than death…well, maybe it’s worth it for the discredited hogwash that generated mercury-in-vaccine hype.

Then there is the MMR which doesn’t contain thiomersal (it works on a different principle and thiomersal would destroy the vaccine). The theories are that the three elements of the MMR overwhelm the body’s defense mechanism, causing autism, and that these should be given individually instead of combined. Of course they are given combined because all three elements – measles, mumps, and rubella – can be dangerous or deadly. Ironically, rubella is one of the few known causes of autism – when the mother has rubella in pregnancy, birth defects are a too-common result. And you get rubella by not getting vaccinated (note that there is no link in children getting rubella and autism). So the very act of people not getting the MMR (uh, to supposedly avoid being given autism) is likely to increase the prevalence of autism! But the idea with giving all three at once is that it is much easier to accomplish. Instead of a child needing to see a medical facility three times, and have proper records and such, it’s one visit. One visit is easier than three, particularly once the diseases are mostly under control (and thus not seen as a reason for rushing to the doctor to prevent). Plus, most people’s experience with the mumps or measles is that “you get over it.” Often, you do. But it still can have lifelong effects. For instance, the mumps, while not causing autism, can cause deafness, impotence, miscarriage, meningitis, encephalitis, and even death in some cases. And while these things are rare, they are more common than it causing autism! But even so, the call for separate vaccines persists – despite it meaning less people will get the vaccines, and it being bad medical science to cater to people who hold irrational fears of medicine.

But, when the medical professionals shouted about “MMR DOESN’T CAUSE AUTISM” AND “THIOMERSAL DOESN’T CAUSE AUTISM,” people saw it as a cover-up. It was the medical community protecting themselves. And then came people with Brockovich Syndrome – they “discovered” the connection between giving their child a vaccine and the child “developing” autism, usually with a dramatic fever at some point shortly after the vaccine. Medical science says autism is clearly not related to vaccines. But that’s not enough to cause someone to think that it doesn’t, if they think they’ve made the connection.

Oh, on Erin Brockovich and her findings of contaminated water causing the unusually high prevalence in Cancer? Some skepticism may be warranted.

A Rule to Avoid Being a Creep

Autistic people like clear definitions and rules. Some things don’t have good rules.

One thing that doesn’t lend itself to creating fixed rules is any type of relationship – whether a friendship, a romance, a one-night-stand, or whatever other type of relationship. People are messy. We’re complex.

But, it’s pretty simple to not be a creep.

First let me tell you what doesn’t make someone a creep: sexual attraction. Even if that sexual attraction isn’t mutually felt by the object of your attraction.

That said, there are a couple parts of sexual attraction, and it’s sometimes useful to separate them out, as they are felt differently in different people. First, there’s the “WOW! She’s VERY attractive!” type of attraction that isn’t based on a relationship. Typically, acting on this is a bad idea – chances are, if it’s a random person walking down the street, that other person has practically nothing in common with you. She might be gay (and you aren’t a woman). Or want to marry someone who can share her love of sailing (and you hate water). Or might not see you as attractive. Or might have completely different life goals than you. Or might not want the same depth of a relationship as you want (she might want a one-night-stand while you want a marriage, for instance). Or any number of other things that would disqualify you as a potential partner in her eyes.

So, acting on phase one of the attraction generally isn’t going to be successful. Of course movies are sometimes based on phase one attraction working to build relationships. Perhaps that’s why they are entertaining and interesting. But movies aren’t real life. And, yes, I know in real life there are sometimes people for whom phase one attraction was the only reason they met and things have worked out mutually well. That’s fine too, but it’s not the typical circumstance.

Phase two attraction is a bit different – it’s not just based on looks, but rather it’s something that develops as you get to know a person. This doesn’t mean that phase one isn’t there (someone can be both attractive initially and attractive after you get to know them!), but it is in addition. I think a lot of long-term partners would describe this as making their love life better – the combination of phase one and phase two can be very powerful and exciting (far more than phase one alone for many people). Perhaps this is why 1/3 of men seeking prostitutes seem to desire an emotional relationship with the prostitute – they are looking for that phase two combined with feelings of mutuality. The emotional attraction that comes with phase two is not separate from the sexual attraction – it actually creates a powerful sexual attraction. In many people it is even deeper than the phase one sexual attraction.

This phase two attraction is a bit different. As you get to know people – and sometimes this can happen surprisingly quickly – a mutual emotional connection might be formed, which increases the sexual desire of both. I’d encourage people to look more for this than the phase one attraction, while not denying the existence of either.

So, that’s my thoughts on general principles. Back to the rule. We’ve already said that sexual attraction doesn’t make someone a creep.

What makes someone a creep is simple: Creeps don’t care if there is mutual agreement about how to proceed in a relationship. If it doesn’t exist, they think they can create it – and try to do so. It’s an emotional, psychological, and sometimes physical violation.

That’s where you can get in trouble with the phase one sexual attraction. It’s almost certainly not mutually felt. The phase two attraction might develop as you and the other person get to know each other, but there’s probably more chance it won’t. Just randomly acting on “She’s pretty, I want to get her in bed,” is likely to meet with failure after failure. That getting to know her thing – even if it doesn’t make good movies – is important.

And, then, as you get to know someone, you don’t proceed without mutual agreement. Occasionally you might “test the water” and see if the other person wants to go a bit further in the relationship, but, if not, you have one thing to do if you don’t want to be a creep: listen. If she sees you test the water, and then gently lets you down, respect that and enjoy what you have with her – friendship or whatever else. Don’t try to figure out what different tactic you can try. She knows you’re interested, she’ll initiate if she changes her mind (she probably won’t). And, yes, even in western society women can and do test the water too. So listen for that too.

Of course I can see people asking, how do you test the water? I can’t tell you that. Each relationship is different. There is no formula, no matter what the pickup artists out there may tell you. Everyone is different. Just respect her if she says she’s not interested. Don’t try a different tactic, respect her. And if you keep persisting, and thus become a creep, don’t be surprised when she gets a little more forceful in rebuking you. She’s not a bitch, nasty, or whatever else. You were a creep.

If you allow her to think you are happy having a friendship, while really you want her in bed, and you won’t be happy with it remaining a friendship without sex, you’re also being a creep. You don’t have mutual agreement about the relationship. She’s thinking, “Oh, a friend! That’s cool.” You’re thinking, “How much longer do I have to put up with pretending to be a friend before I can get her in bed?” You’re not in agreement. You’re setting her up and trying to deceive her to get what you want.

It’s risky to say what you want. And if what you want is good for you but not good for her, she’ll probably turn her down if you allow her to do so (not allowing this would also be creepy). But part of coming to an agreement on a relationship is to communicate and understand where the relationship is at. For me, I can’t do that the way neurotypicals do. The slight and subtle hints and body language doesn’t work. So I need to try to be honest. But there are few things harder in the world than being honest and vulnerable. So I think autistic relationships – particularly between two autistic people, but also likely between an autistic person and a particularly understanding non-autistic, can look a bit different. Some things might need to be more explicit. A challenge is trying to make those things clear while not destroying the mystery and spontaneity of a relationship. It takes someone who understands.

I wrote this mainly from the perspective of a man looking for a woman, but it applies in all sorts of other relationships too. Two people might agree to have quick sex without an emotional connection – or three people might want to do something sexual together. That might be unusual, but it’s not creepy so long as you mutually agree on where and what the relationship should be. And you can be a creep without even seeking sex but seeking whatever else instead. Forcing a friendship to progress can be creepy just as trying to get the girl in bed can be.

So, don’t be a creep. Respect and mutuality.

What is Romance?

I’ve long seen discussions on autistic forums that seek to find a nice, clear, universal definition of terms like “romantic relationship.” What is the difference between two good friends, maybe who share an intimate understanding and connection, and two people who are in a “romantic relationship?”

Like many things, the answer isn’t simple. We humans are pretty darn messy. We don’t fit nicely into categories. Sure, you might be able to find categories that fit 90% of us 90% of the time, but there will always be the messy, fuzzy edge.

That’s okay.

First, does it matter if your relationship is a romantic one or a friendship? If it doesn’t matter to you, I wouldn’t worry about it. But if you are very concerned about whether or not a relationship is “romantic”, then I suppose it matters.

The only definition I believe is valid is “Do you and the other person involved think it is a romantic relationship?” If so, it is. If not, it isn’t. Simple.

But of course there are always some people who dislike the idea of having to take someone’s word for their own life. We all would love a world where we could see, objectively and without any dispute, whether or not someone is in category A or category B. Sorry, it doesn’t work that way.

Things do get complex because plenty of people do try to give a definition of a romantic relationship. For instance, sex usually comes up as a differentiator between romance and friendship. But that falls on it’s face – not all people who consider themselves romantically involved have sex, whether it is for medical reasons, dislike or lack of interest, or circumstances (long distance, for instance). Nor do all people who have sex feel they are in a romantic relationship – certainly people who have sex forced on them don’t feel that way, nor probably do prostitutes, nor do people who want a casual fling. So sex doesn’t make a romance.

Certainly, sex is intertwined for many people with romance – I know I personally would not want to have sex with someone I’m not in a romantic relationship with. Among other things, and without going into details, the relationship frankly makes sex better . The most important sex organ is the brain, after all. So an intellectual and emotional connection associated with what I call romance is important to me. But sex doesn’t make or break romance, at least not universally.

For me, romance is between me and one other person. Someone else may have different ideas. I think emotions, intimate sharing, trust, and respect are really important to make something a romance. Sure, these things can also exist in friendships. As can other elements, such as a mutual commitment to each other. So what distinguishes close, long-term friends who are committed to each other from a romance? I don’t know. For me, it’s the spark and desire – I’ve had plenty of close friends over the years. But my wife is different. It’s even more intimate and closer. And I’ve made a commitment to her I’ve never made to another person. I’ve had friends where I would drop pretty much anything to help if needed (and they felt the same). But this is different. It’s not just helping. It’s having my identity and hers intertwined in a way that is beyond help, beyond support, beyond wanting the other person to have a good life.

For me, my life and my wife’s life are combined. We don’t live separate lives. We live a life where her well-being, happiness, and success are just as important to me – if not more important – than my own. And she has that same concern for me. Certainly, I’ve wanted friends to have well-being, happiness, and success, but it’s just different.

And that’s part of the problem. Romance isn’t logical. It’s not definable. I can’t tell you in black-and-white terms what makes this relationship I have with my wife completely different than relationships I’ve had with close friends. And certainly I had no idea it could be different until I experienced this relationship. I had no frame of reference. I had never experienced this spark.

But I do believe autistic people can and do feel the spark. Now some people may go through life without ever feeling romantically attracted or attached to someone. Others feel the desire for this from an early age and know that it is out there for them to find. Yet others, like myself, don’t feel the spark or even the desire until they run headlong into it – and then it burns but doesn’t consume within their heart and soul. Not their logical processing unit!

I do think most people – including most autistic people – can feel this spark. Too often, autistics are told we can’t. Too many public examples of autistic people are people who don’t feel the spark, so it’s easy to feel that may be a universal experience. Of course it’s possible to not feel it, not want to feel it, and still live a completely full and wonderful life – I do reject the “My kid will never know what romance feels like” type of garbage I hear some say for both reasons. I reject it because it may not be factually true (we can’t know if someone will or won’t feel it, autistic, neurotypical, or otherwise). And I reject it because I and you have no right to push our hearts’ desires onto a kid who may or may not want or need those desires to be happy.

I would suggest to that hypothetical autistic kid, if he were my kid, or if he asked me for advice, the following: if you don’t feel the need for romance in your life, that’s fine – no point in trying to change that or to feel defective. It’s a perfectly wonderful way of living! As Song of Solomon says, “do not awaken or arouse love until it so desires.” But, at the same time, just because you don’t feel it today doesn’t mean it won’t impact you powerfully tomorrow – so don’t close yourself off to the possibility either. If it happens, let it happen. If it doesn’t happen, let it be. Don’t force it and don’t prevent it.