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.

Why I Haven’t Been Posting

I’m about to get back to things.  Over the last two weeks, my wife spent several days in the hospital.  We then had the non-trivial task of making sure that the CO level in our home returned to normal, as well as allowing my wife to rest and recover.

So I’m back now.  Things are getting back to normal.  But I was less concerned about posting here than paying attention to the important things going on in my life at the time.

Another Reason to Support Vaccines

Vaccines save lives.

Seriously.  Even for diseases you don’t think kill.

I’m not going to argue about whether they cause autism.  They don’t.  That’s scientific fact.  We don’t need additional studies.  It is clear, verifiable, easily researched fact.  Just like the earth is round, not flat.  Not understanding this doesn’t make your opinion any more true – vaccines have nothing to do with autism.

But they do have everything to do with both your and other people’s well being.  Even your life.

A family member came down with whopping cough a month or two ago.  He’s a bit older than me.  Up to this point, he was pretty healthy.

He’s still got a cough, but much of it was getting better.  During the worst of it, he coughed so hard that he broke his ribs.

He would cough hard and long enough to lose consciousness.

In a complication from this, today he was rushed to the hospital while having a heart attack.  Fortunately, everything lined up perfectly in this man’s life and everyone did exactly the right things – he’s recovering now.

It was a blood clot from his lung that cut off blood flow to part of his heart.  A blood clot most likely due to the damage he did to his lungs coughing.

It took an emergency procedure, amazing medical technology, and a stint to keep him alive.  Fortunately we have some wonderful, life saving procedures and devices today.  It took a bunch of them to keep him alive.

One of those amazing things we have is vaccines.  This is what “just” whooping cough can do.  Don’t let your kid spread something that will kill someone else.  And certainly, if vaccines are recommended by the medical authorities for you, GO GET THE DARN THINGS.  You might save your life.  Or someone else’s.

If you’re an adult (19 or older), the CDC recommends a Tdap booster every 10 years.  The Tdap includes the Whooping Cough vaccine.  (children also have recommendations for being vaccinated against Whooping Cough – that information is easily available online)

The Catholic War on Women – How it Affects Autistic Women

There’s been a subtle battle in the USA over the role of religion in health care.  The question at the heart of the battle can be paraphrased as, “Does a religious institution running a hospital need to provide women’s services that it finds religiously offensive?”

It’s been a battle in part because people are surprised to find out that their hospital is managed by a Christian (typically Catholic) group.  For instance, I was surprised to find out that my nearby hospital, which used to be Lutheran, is actually now owned by an organization that requires the hospital to adhere to Catholic principles.  My next closest hospital, likewise, is owned by a different organization that requires the hospital to adhere to Catholic principles.

That probably wouldn’t bother me if the hospital’s door’s said “Catholic” on them somewhere.  I’d know what I could and couldn’t expect in that hospital, and others would equally have warning.  I’m not Catholic – so I don’t want treatment that is a subset of the treatment I’d get at other hospitals, just as I wouldn’t go to a Christian Science care facility (I drive past one to get to the closest hospital).  But, no, they don’t say Catholic. They give a Saint’s name or a historical name.  For instance, I live near “Exempla Lutheran Hospital.”  One would think that hospital follows Lutheran principles, or perhaps some corporate for-profit principles of some company called Exempla.  However, you would be wrong on both counts.  Exempla is a non-profit organization owned by two groups – a Catholic charity and a non-profit community group.  However, the Catholic charity has exerted enough control to require the hospitals in the Exempla system to follow Catholic principles.

I know, this sounds like conspiracy-theory – the Pope secretly controlling the UN as part of Agenda 21 and injecting Floride into our drinking water so that he can round up all the gun owners and put them in concentration camps under Denver’s airport.  Or something.  But I’m not the only person concerned about this application of Catholic principles in a relatively hidden way.  See also their own words – Exempla’s ethical and religious directives, which they explicitly state that the non-Catholic Lutheran Medical Center will follow.  These directives include following Catholic teachings in the master Ethical and Religious Directives put out by the US Conference of Bishops.

Before I delve into this, again, this is a hospital that never says they are Catholic.  In fact, it’s a “Community Hospital” according to Exempla’s own words.  Yet it must abide by Catholic directives.  This is my biggest area of concern (my second area of concern is that some areas only have one hospital nearby, limiting the choice where someone may go to only hospitals that practice Catholic beliefs) – it’s simply false advertising.  The other nearby hospital is part of “Centura Health” – again, it looks like a pretty secular name.  Yet it, too, is Catholic and abides by Catholic principles.

What does this have to do with autistic people, other than incidentally?

Here’s a handful of group homes that are managed by Catholic charities:

So my question is: first, why the apparent desire to disassociate the organizations from the Catholic Church, just as with hospitals, by avoiding the word “Catholic” in the groups’ names and websites (with the exception of the last one listed above)?  Who would know HeartShare, for instance, is Catholic, particularly when it’s website just references them being a non-profit?  Why the need to hide?

My second question is, “What Catholic teachings are followed when operating these homes?”  I don’t have any problem with someone showing the compassion of Christ.  But I probably do have problems if sexual education is taught only in a way that fits Catholic doctrine, particularly if the resident is non-Catholic.  Do residents have the option to seek birth control?  Seek sterilization (I’m not talking forced sterilization, which I oppose strongly)?  Chose whether or not they are taken to a Catholic hospital in case of a medical need?  Are the rules around same-sex romantic relationships between residents the same as those around opposite-sex romantic relationships (in general, the answer here across all group homes, is no – there’s distinct homophobia in many group homes studied in past studies)?

Once again, I’m fine with people choosing to abide by Catholic teaching.  I’m just not fine with the ideas of deception in naming organizations (Exempla Catholic would be fine – Exempla alone is not) that are going to apply religious doctrine to my treatment, nor am I fine with people not having a choice to seek treatment that fits their own religious beliefs if those differ from those of a particular organization.  I fear most group home residents have relatively little say in this process.

For what it’s worth, here’s some things to know about Catholic hospitals, from the Bishop’s ethical and religious directives for Catholic and Catholic-affiliated hospitals:

On Directing Your Care

28. Each person or the person’s surrogate should have access to medical and moral information and counseling so as to be able to form his or her conscience. The free and informed health care decision of the person or the person’s surrogate is to be followed so long as it does not contradict Catholic principles.

On Rape

36. Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.

On Fertility Treatments

38. When the marital act of sexual intercourse is not able to attain its procreative purpose, assistance that does not separate the unitive and procreative ends of the act, and does not substitute for the marital act itself, may be used to help married couples conceive.

40. Heterologous fertilization (that is, any technique used to achieve conception by the use of gametes coming from at least one donor other than the spouses) is prohibited because it is contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child.

41. Homologous artificial fertilization (that is, any technique used to achieve conception using the gametes of the two spouses joined in marriage) is prohibited when it separates procreation from the marital act in its unitive significance (e.g., any technique used to achieve extracorporeal conception).

On Tubal Pregnancy

48. In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.

On Surgical Birth Control

53. Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.

On Beliefs…

I’m not saying that any of the above beliefs are wrong to hold. In some cases, I might even agree with them. But there’s a difference between having a belief forced upon me and allowing me to hold a belief. When I’m getting medical care, it’s my beliefs that matter to me, not my hospital’s.

There’s a lot of stuff in the Catholic teachings that most people would disagree with (even many Catholics), such as requiring the removal of a Fallopian Tube to preserve a mothers’ life in the case of a tubal pregnancy, rather than a simpler, less risky, and less-likely to sterilize abortive procedure.

I am not against Catholics following their religion.  I just don’t want to have to follow it too.  Nor do I want others in vulnerable situations, such as non-Catholic rape victims or autistics living in group homes to be prevented from following their own beliefs and views.

I want to see legislation that requires state and federally funded medical institutions, care homes, and disability services to disclose any religious affiliations they follow.  I also want to see state or federally funded non-religious alternatives within any geographic service area served by a state or federally funded religious institution.  People deserve the choice to follow their own religious beliefs when it comes to their medical treatment or their home living environment.  Even if they are a vulnerable rape victim or a developmentally disabled adult.