English Language & Usage: Multi-Layered Discourse Room

Cerberus

00:00

Oh, interesting.

alphabet

I take diphenhydramine fairly often to fall asleep, but I hear that now they think it increases dementia risk.

Cerberus

Oh, interesting.

I can see whether drug stores sell that here.

M.A.R.

@Cerberus there is, yeah. And there are also nuclear options. For example, a chlorpheniramine ampoule is 2.5 times stronger than its pill. It works so well it's used to prevent anaphylactic reactions to chemotherapy drugs

alphabet

Also: the bottle says it's "non habit-forming," but I call BS. If I take it for more than a few days in a row it stops working.

Cerberus

@alphabet Does it work well for you, aside from the dementia?

@M.A.R. Oh...and is that more effective than taking 2.5 pills?

M.A.R.

00:01

@alphabet tolerance is not dependency. An essential element would be cravings

alphabet

@Cerberus Yes; it's sold over the counter as a sleep aid, where you can get it in 300-pill bottles, so apparently there are people who take it quite regularly.

Cerberus

OK.

alphabet

The brand name here is Unisom, but most pharmacies also sell cheaper generics. Of course it's also sold for allergies as Benadryl. The difference is that the former comes in blue pills, whereas the latter comes in pink pills.

M.A.R.

@alphabet because the active sites of muscarinic receptors in the brain are similar to histamine receptors, all 1st gen antihistamines have a little bit anticholinergic activity. It's of course not as much as atropine, for example, otherwise high therapeutic doses of antihistamines would cause the typical symptoms easily (blurred vision, urinary retention, constipation etc.)

alphabet

Leading to the odd situation where pharmacies sell two near-identical generic diphenhydramine products, but in different pill colors, so that they can compete against different brand names.

M.A.R.

00:05

I know that they're not very kosher in old patients suffering from dementia, but do the guidelines also caution against using them as sleeping aids in young patients?

I dunno. Have to look that up.

alphabet

Same thing with Ibuprofen. My local CVS sells CVS-branded ibuprofen in orange pills to compete against Motrin and CVS-branded ibuprofen in brown pills to compete against Advil.

@M.A.R. I heard somewhere or other that they now think the risk is fairly high if you're taking them regularly, even at a young age.

Cerberus

Doesn't your drug store sell its own house brand?

M.A.R.

They're certainly superior to other pharmacological options: Melatonin is a placebo, benzodiazepines are terribad, and z-drugs are still addictive

Cerberus

Here drug stores have their own house brand of most normal pills.

alphabet

@Cerberus Yes, that's what I'm saying.

M.A.R.

00:07

@alphabet that's dumb

Though not dumber than half of what's going on here so

Cerberus

@M.A.R. I read this too, long ago, that melatonin was a placebo except for a certain subclass of old people. And yet so many people swear by it...

alphabet

They usually sell both the brand name drug and the store-brand generic version. The latter is cheaper, but people trust the brand name more for whatever reason.

Cerberus

@alphabet Ah OK, I didn't know the names and abbreviations.

So everyone just buys the cheapest option, right?

M.A.R.

@Cerberus such a thing would be hilarious here. It's not confectionery

Cerberus

@alphabet Sounds American haha.

alphabet

00:10

@Cerberus I suspect sales are about 50/50. Some people are absolutely convinced that the branded version works better.

Cerberus

@M.A.R. Well, it is more like, when you see the house brand, you know it is the cheapest option with the same content. That's all it is.

@alphabet Right, or they might just not think about it too much, especially not when they feel sick.

I don't think I have any pills in my house which aren't house brand or generic prescription.

M.A.R.

@alphabet because they ask a pharmacist once which option is better. And even if drugs aren't easily advertised brand names are big flashy advertisements for MDs and PharmDs.

alphabet

@M.A.R. When my depression was really bad and I couldn't sleep for more than 5 hours a night, they gave me a low dose of quetiapine. I'd wake up 3-4 hours later with all the lights in my bedroom still on.

M.A.R.

@alphabet also moderately antimuscarinic

alphabet

@M.A.R. I don't think they ask the pharmacist. But I think it applies to most things--store brand yogurt is usually worse than the brand-name kind, so people just assume it's the same way with medications.

M.A.R.

00:13

But what was going on there is whatever makes depressive/anxiety/bipolar disorders better also alleviates the symptoms: Better sleep, appetite, mood etc.

Cerberus

@M.A.R. Hmm I have never seen that happen here! No doctor or pharmacist has ever recommended a more expensive brand (except when he really felt that there was a difference).

@M.A.R. That makes sense.

M.A.R.

@Cerberus well the placebo effect says something is subjectively or objectively happening. But eating paper would achieve the same effect, so it must not be melatonin itself doing anything

alphabet

@M.A.R. I think the dose (25mg) I was on was too low for it to be much more than a sedative. And I was supposed to only take it "as needed."

M.A.R.

Like a last last last resort?

Cerberus

@M.A.R. Yeah but it is so interesting to me how people do not WANT to research the stuff a little bit.

alphabet

00:19

@Cerberus Every couple years they come up with a slightly different formulation of Advil (ibuprofen) and start an ad campaign for it.

Cerberus

@alphabet I have not heard of that here; is that what happens in your country?

alphabet

Advil | Liqui-Gels

►

Cerberus

I never see any advertisements anyway.

alphabet

It's ibuprofen, but in capsules full of liquid, and therefore supposedly better for some reason.

Cerberus

You can buy house-brand capsules here.

Supposedly, the effect is a bit quicker than with a pill?

alphabet

00:23

Allegedly.

Cerberus

By the way, I also heard someone say that cutting open such an Ibuprofen capsule and rubbing the liquid in a pimple helped against inflammation locally. Or you could crush a pill and make a paste. Would that seem realistic @M.A.R. ?

alphabet

Advil Dual Action | Period Pain :15

►

Now they also have a kind that includes both ibuprofen and acetaminophen.

Cerberus

It seems so needless.

M.A.R.

@Cerberus research melatonin? Well, there's a sort of bias that I can't name . . . Obviously it's supposed to be 'evidence-based medicine' so my typical retort for cash grabbing placebos in the market is "where's your RCT? Huh huh huh?" But realistically people that can do good research avoid what's already built on shaky ground like the plague. There's nobody out there to do some Mythbusters work on whether if any of the hundreds of supplements I sell at the pharmacy actually do something

Cerberus

I mean, unless you need to take a very large number of pills every day.

alphabet

00:24

And ads about how it lets you go to parties while menstruating.

Cerberus

@M.A.R. What is RCT?

M.A.R.

@Cerberus Sorry, Randomized Clinical Trial

Cerberus

Example: when I wanted to sleep better, I looked at what the drug store had for sale. I saw melatonin, and I Googled it. When I found a credible source, it said that melatonin was not effective except for special groups of old people. How hard is that?

CowperKettle

@Mitch Last year, there was a very interesting publication that indicated the presence of four 'activity types' of depression (measurable by brain activity pattern). But I have no IQ to read it in-depth

M.A.R.

@Cerberus yeah I've heard of lifehacks like those. It's impossible to predict whether ibuprofen would be absorbed by the skin. Because of its structure and chemical properties It's not unlikely a fair bit is absorbed. But the only answer you can be certain of is it's not designed for that, and there are easily accessible solutions for pimples.

CowperKettle

00:28

Six distinct types of depression identified in Stanford Medicine-led study

Six types, not four - nature.com/articles/s41591-024-03057-9

M.A.R.

@Cerberus well at least as hard as not treating Wikipedia as a primary source

Cerberus

@M.A.R. But are there really? The only thing that works topically for me is an antibiotic, and I can't use that all the time.

@M.A.R. Hah.

Maybe the antihistamine helps a bit. Still not entirely sure, because it comes in waves anyway.

alphabet

@Cerberus I've heard of people using hydrocortisone--the anti-itch cream--for that.

M.A.R.

@Cerberus if it really is a pimple, a topical antibiotic is reasonable. But if it's acne, since you're not considering becoming pregnant, tretinoin is a good option

Cerberus

@alphabet Ah, I do not know it.

CowperKettle

00:31

Common Sleep Aid May Leave Behind a Dirty Brain

Cerberus

@M.A.R. Right, but tretenoin is only preventative, it won't clear a pimple, will it? It has never done that for me.

But I found it too hard too use anyway.

alphabet

@M.A.R. Here they sell an absurd number of different OTC acne products. Only the topical kind; I hear even dermatologists are reluctant to prescribe tretinoin in pill form.

M.A.R.

@alphabet yeah since 'pimple' isn't a distinct medical category. If it's any type of dermatitis, for the face hydrocortisone is reasonable, and for the body you could try something a bit stronger, like triamcinolone

CowperKettle

@Cerberus Antihistamines should be avoided if possible, because anticholinergic action (anticholinergic burden) negatively affects cognition

alphabet

@Cerberus Usually advertised/used for mosquito bites and eczema.

M.A.R.

00:32

@alphabet gel not pill. Yeah isotretinoin has some serious side effects.

CowperKettle

Antihistamines and brain atrophy: jamanetwork.com/journals/jamaneurology/fullarticle/….

alphabet

@M.A.R. Topical adapalene became OTC a few years ago and works quite well.

M.A.R.

@Cerberus no, totally curative. It increases skin turnover, so if it's not a one-off thing and keeps coming back, the standard treatment is something a bit more long-term

@alphabet adapalene, tretinoin, and tazarotene (among a few others) are all vitamin A derivatives used for this purpose. Their main difference is in the side effects.

alphabet

I also take the antidepressant mirtazapine (long story) which apparently is also a really strong antihistamine, which explains its side effects. (It also maybe probably causes dementia.)

Cerberus

@CowperKettle I think that mainly applies to the first generation of antihistamines, based on what MAR says? And probably only if you take them regularly anyway?

M.A.R.

00:37

Tazarotene is more potent but more sensitizing, for example. Tretinoin sometimes causes hyperpigmentation, while tazarotene is IIRC more prone to cause hypopigmentation

@Cerberus if a few milligrams of cetirizine caused dementia we would probably have had to eliminate half the spices from our foods

alphabet

I can probably start tapering off it now, though.

M.A.R.

@alphabet bad bad idea, these combination painkillers

alphabet

TYLENOL® Greatness Hurts™ | Care Without Limits™

►

Tylenol, of course, makes you better at sports.

Cerberus

Hmm maybe the acute effect was slight, then, because I never really noticed that. Or my pimples were too big. It did help reduce acne long term; but my skin began to hurt from it after regular application. And it is just so much effort to rub it onto my entire back, I just couldn't stick to the prescription. So I quit.

And I still use the Ibuprofen which you will scold me for...it works super well. About 100 or 200 mg on an average day (I only take it after I have slept less than 7 hours, and then I normally take 200 mg).

@M.A.R. Oh, that's fun!

@alphabet Hmm maybe we have something like that here too.

M.A.R.

Here there's a paracetamol/ibuprofen/caffeine combination that I spend at least an hour a day in the pharmacy driving people away from. That combination sorta strangles the nephrons in the kidney

CowperKettle

00:41

> If God closes a door to teach a man to fish, make lemonade

M.A.R.

If I have a very bad headache, toothache, what have you, I will take high doses of paracetamol only. If you haven't turned your liver to stone with alcohol, you can take 4 g of paracetamol a day. That's much superior to these kidney-killing painkillers.

Cerberus

Ahh yes, they sell paracetamol with caffeine here too, that always seemed weird to me.

@M.A.R. Do you need to spread that out? The box says you do?

M.A.R.

@Cerberus each of the three I mentioned are slightly bad for the kidney. Together, they mess everything up down there.

Cerberus

That's not good.

alphabet

@M.A.R. Here they sell it as a migraine treatment, Excedrin.

M.A.R.

00:44

@Cerberus taking 8 500 mg pills at once seems a bit excessive. You can spread it out as you like though.

CowperKettle

> "Even a short duration of treatment with the new COX-2 inhibitor etoricoxib may have the potential to precipitate renal failure and life-threatening hyperkalemia"

Cerberus

I don't see the point of combination drugs in those cases.

M.A.R.

@CowperKettle they tried to come up with COX-2-selective inhibitors to prevent the gastrointestinal upset caused by typical NSAIDs. Turns out it's bad for the kidneys and the heart. The very selective COX2-inhibitors caused heart attacks and were withdrawn in the 2000s

alphabet

@M.A.R. Huh. Here all the paracetamol bottles have extremely scary-sounding warnings on them about how dangerous it is to take too much.

CowperKettle

@M.A.R. I took several tablets of etoricoxib in April 2018, and developed persistent mild hyperkalemia, and bouts of severe fatigue and elevated cortisol

M.A.R.

00:48

@alphabet having aspirin instead of ibuprofen means it's a bit safer for the kidney but will make a neat whole in your stomach so you can put your finger in and it would come out from your back. So yeah stay away from Excredin

alphabet

I've discovered that (at least for me) naproxen works a lot better than any of the other OTC painkillers.

M.A.R.

@alphabet because it's the most common drug responsible for intentional and unintentional poisonings

Cerberus

@alphabet Better than Ibuproflen? Against what kind of pain / where?

OK I am taking two more paracetamols, I think I can feel the fever increase.

M.A.R.

@alphabet my next choice after paracetamol would be an NSAID. NSAIDs are totally individual in their action. For some inexplicable reason, naproxen works for you, diclofenac works for someone else and a third person swears by meloxicam.

Cerberus

Fun!

@M.A.R. That is so strange.

Is any of them less harmful than the others?

M.A.R.

00:52

@Cerberus a fact which helps these combination painkillers proliferate.

alphabet

@Cerberus Aches due to colds, sore muscles, etc.

Cerberus

Oh, I don't remember seeing combinations of several NSAIDs.

@alphabet OK good to know.

alphabet

@M.A.R. I believe naproxen and ibuprofen are the only OTC ones here, so it's usually one or the other.

Cerberus

And stomach/gut cramps?

alphabet

@M.A.R. Yeah, I think the scary warning labels may have the unfortunate effect of causing more intentional self-poisonings.

M.A.R.

00:54

@Cerberus Naproxen is the NSAID of choice for people who have done heart surgery or have heart diseases. Celecoxib and meloxicam are pretty COX2-selective, so they have been shown to lower rates of GI upset in the first 6 months of use. Some have more pronounced adverse effects than others. Ketorolac absolutely ruins people's stomachs. Indomethacin is terrible, no one should go near it in this century

@alphabet Meloxicam 7.5 should be OTC, 15 should be Rx-only

alphabet

@Cerberus I don't have those often.

Cerberus

@M.A.R. So for the average 'healthy' person, would elecoxib and meloxicam be better, or ibuprofen?

I don't think I normally feel any stomach upset from ibuprofen.

M.A.R.

@Cerberus usually you find and treat the underlying reason for gut cramps instead

Mitch

@M.A.R. holy crap. How about just a little for headaches every so often?

Cerberus

@M.A.R. What if it is a temporary problem and/or it can't be treated that way?

alphabet

00:57

If my stomach is upset (like nausea) I usually take Pepto-Bismol. Kind of odd to take an aspirin derivative for stomach issues--I assume the odd chemical composition means it doesn't have the burn-a-hole-in-your-stomach problem.

I also hear nobody really knows what the bismuth in it does, if it does anything.

Cerberus

Interesting.

Mitch

Makes the name really pop

M.A.R.

@Cerberus paracetamol is superior to all NSAIDs if it works. All NSAIDs eventually cause upset stomachs on chronic use. They all elevate the blood pressure. They're all "slightly dangerous" for the kidneys and the heart. Not to mention some very rare side effects that have probably only been observed because so many people use these. But, to answer your question, depends on why you're taking it

alphabet

Bismuth subsalicylate is the generic name.

M.A.R.

If it's knee pain, for example, it's bound to hurt for a few weeks, so meloxicam and celecoxib are prescribed more. For a toothache that will only last a couple of days, ibuprofen is no problem

Cerberus

01:00

Ah, OK.

So, if both ibu and celecoxib work equally well, the latter should be chosen?

Assuming that paracetamol does not help.

By the way, is it a good sign if one has never noticed an upset stomach after taking ibuprofen?

M.A.R.

@Cerberus just cramps, hyoscine tablets. There could be flatulence, diarrhea, constipation, infections that aren't self-limited and need treatment, lactose intolerance, autoimmune diseases of varying severity, etc etc. which will need their special regimens

tchrist

@M.A.R. I can confirm your indomethacin appraisal.

M.A.R.

@Cerberus yes, if there are no underlying kidney problems

tchrist

@M.A.R. I couldn't imagine taking pain meds for gut cramps. But serious cases of obstipation can certainly be excruciating.

M.A.R.

@Cerberus a lot of people don't experience even the most commonly documented side effects of drugs. There's also the fact that usually you won't feel anything in your stomach until things get pretty bad. That protective mucosa is pretty tough.

Cerberus

01:05

@M.A.R. That's interesting. I read about hyoscine, that it is only absorbed once it reaches the place in the guts where such things are absorbed, meaning that it will take a long time to have any effect?

@M.A.R. Noted.

tchrist

You certainly need to make sure you know what it is. I've known people to land in long hospital stays because they didn't quickly get a proper diagnosis and treatment for gut pain when it turned out to be a bleeding ulcer.

And no, not me. Other people.

Cerberus

Some kidney stuff of mine is tested occasionally, so I assume that'll be all right. I'm generally systemically healthy.

@M.A.R. So that means, if you don't notice any stomach upset, that doesn't mean the NSAID is any less harmful to you personally?

M.A.R.

@tchrist hypscine is anticholinergic. And the pill is butyl bromide, ionized, so it doesn't get absorbed to any appreciable extent, meaning it almost never has any side effects. It simply prevents the neurons in the gut to constantly tell the muscles to contract and spasm. Of course, the reason for the spasticity should be known and we shouldn't mask an important symptom if it's for example a flare-up of Crohn's

@Cerberus yep

Cerberus

Noted.

I should see my doctor haha.

Mitch

@Cerberus haha

Wait

Cerberus

01:09

Funny, isn't it?

Mitch

Depends

Jokes when leaving a funeral: funny

M.A.R.

NSAIDs damage the gut mucosa in two ways: Because of the acidic pH, they lose their negative charge, become less soluble, precipitate and cause damage, not unlike how fairly strong acids would irritate the skin. And they're also thinning the mucosal layer because that's simply an extension of how they work in the body, suppressing inflammation and pain

Mitch

Jokes on the way to the hospital: not fun y

Cerberus

And they can also harm the heart...

@Mitch Oh, it's nothing like that.

M.A.R.

@Cerberus the pill doesn't. Just acts locally, in the gut. So the effects can be felt in half an hour.

Cerberus

01:11

This week, I have taken maybe 400 mg of Ibuprofen in total.

tchrist

@M.A.R. Do PPIs like esomeprazole lessen that effect?

Cerberus

@M.A.R. Oh, I assumed, if the pain was in the bowels. So far below the stomach.

Anyway, don't you get tired of all our questions!!

tchrist

I'm not convinced that everyone can always tell where their pain is coming from.

M.A.R.

@Cerberus yeah that's what I meant. The effect starts at the duodenum

Cerberus

You're such a kind and helpful person and pharmacist.

4

Let me Google how long it takes for food to reach the 'final' end of the digestive tract.

tchrist

01:14

Which food? :)

Cerberus

Like a medicine. That pill.

M.A.R.

@tchrist stomach acid tends to add insult to the injury, whether caused by H. pylori or drugs like NSAIDs. When you suppress that acid, you give the stomach time to heal. Yeah, PPIs can both prevent and help heal GI ulcers

Cerberus

> All in all, the whole process — from the time you swallow food to the time it leaves your body as feces — takes about two to five days, depending on the individual.

tchrist

Yes, unfortunately.

Cerberus

So, if you take a pill of hyoscine butylbromide to ease pain in the lower intestines, it could take a long time to work?

If the pill only works locally on the inside of the gut.

M.A.R.

01:18

They're not usually indicated due to NSAID use alone.

Mitch

I like the idea of a pill cam...you swallow a mini go pro, wait for it to come out, and then watch the slo-mo rollover coaster ride

M.A.R.

Other drugs bad for the stomach include anticoagulants, antidepressants, bisphosphonates (drugs for osteoporosis) etc.

Mitch

A very small go pro

With no edges

Cerberus

Will it have Wifi?

tchrist

NOT the image I'd intended!

Cerberus

01:19

Hah!

tchrist

I give up.

Cerberus

What were you trying to do?

Mitch

@Cerberus hmm...Bluetooth? Lower power needed

M.A.R.

@Cerberus 72 hours on average. If you take a pill on an empty stomach (until almost an hour before or two hours and beyond after meals), and the pill is not especially formulated (fast release for example) it will take half an hour to reach duodenum. On a full stomach, it will take around two hours. For most drugs, absorption starts at duodenum, so you can expect an oral painkiller to start working after roughly half an hour on an empty stomach

Cerberus

@Mitch Smart.

alphabet

01:21

I have heard that there's some hypothetical interaction between PrEP (usually emtriciabine/tenofovir) and NSAIDs, since it increases the risk of kidney damage. I don't think the risk is particularly high, though.

Cerberus

@M.A.R. Oh, and what is the cramps are near the end of the channel?

tchrist

@Cerberus That.

M.A.R.

@Cerberus thank you!

Cerberus

@tchrist Almost the same thing.

Mitch

@Cerberus nope. Smart poop

Cerberus

01:24

@alphabet But when you use Prep, they regularly test some kidney and liver values, don't they?

M.A.R.

@alphabet kidneys are fragile. Almost always when a drug hurts the kidney in some way and another drug in another way, together they hurt the shit out of the kidney. It's because nephrons are very complex structures and break apart easily

Cerberus

Noted.

M.A.R.

@Cerberus that's usually something serious, because there's nothing left for the colons to process, they just absorb water and compact the contents. A cramp there could be an autoimmune problem or obstruction

So when the weak muscle in there is cramping, it's hurting badly and painkillers won't help

alphabet

@Cerberus Yes, usually along with the tests to make sure you're not a vector for any other diseases.

Cerberus

@M.A.R. Ohh well, not that near the end, but let's say near the final 10%?

Won't it take a long time for the pill to finally arrive there?

@alphabet Exactly.

M.A.R.

01:31

@Cerberus it's the small intestine that has the strongest muscle contractions, and a hyoscine pill would relieve pain in there in half an hour. If it's definitely a pill that needs to target the colons, then yeah, unless it's special, it will reach there in two days.

Which is why people use enemas and suppositories instead

Cerberus

Oh, huh.

So food reaches the entire small intestine in half an hour on an empty stomach?

Then where does the food wait for so long before final evacuation?

M.A.R.

@Cerberus big chunks. The stomach is constantly emptying. Smaller chunks, liquids, they get there even sooner.

Cerberus

> Als het oraal ingenomen wordt, kan het niet opgenomen worden in het bloed of op een andere manier het spijsverteringskanaal verlaten, dus het heeft alleen effect op de gladde spieren van het spijsverteringskanaal wanneer het daar langs trekt met de darminhoud.

Dutch Wikipaedia says this.

M.A.R.

@Cerberus you mean in the stomach? The antrum. When the stomach is filled with food, it stretches to fit the contents inside

Cerberus

"When taken orally, Butylscopolamine cannot be absorbed into the blood or otherwise leave the digestive tract, so it only affects the smooth muscles of the digestive tract when it passes there with the intestinal contents."

M.A.R.

01:36

@Cerberus yeah, hence the local effect, and the great safety profile. You can't OD on hyscine butylbromide no matter how hard you try.

Robusto

@GratefulDisciple That'll be the day ...

Cerberus

Right.

So I thought this meant it would potentially take a long time to reduce colics if those happen closer to final stretches of the digestive system.

But I think you are telling me that this conclusion is not warranted?

So, if you have terrible colics right now, it can help quickly enough to take hyoscine butylbromide, so don't need to wait for half a day or longer for the effect?

M.A.R.

@Cerberus radiologists can see the passage of barium sulfate in real time through X-ray. Since its granules are smaller than a pill, it usually gets to the beginning of the small intestine in 15-20 minutes, but can take days before they can take a picture of the colon

Cerberus

Right.

So what if the colics are just before the end of the small intestine?

Won't it take a long time for the pill to have an effect then?

M.A.R.

@Cerberus I'm saying when the colon hurts it's usually not something hyoscine can alleviate anyway. It's a lesion, or an obstruction. Both potential emergencies.

Cerberus

01:41

Maybe I am using the terms wrong...

M.A.R.

@Cerberus it should be roughly around the same time. If not half an hour, then 45 minutes

If you mean the ileum

Cerberus

Ah, OK. So food quickly moves through the entire small intestine, then stays for a very long time in the colon?

M.A.R.

@Cerberus yep. Because peristalsis (the muscle contractions) becomes much weaker

Cerberus

Ok, interesting!

So I have learned basic biology...

Then I understand.

M.A.R.

Okay, now I gotta call it a night

G'night

@Mitch no. Don't go near combination painkillers. Not at all. Not if it comes with a free Toyota.

Cerberus

01:53

@M.A.R. Sleep well.

Mitch

02:07

@M.A.R. I was just suggesting maybe one small aspirin. Also, what kind of Toyota?

tchrist

02:23

@jlliagre Thank you.

jlliagre

@tchrist For the poulette ? :-)

tchrist

Yes. Both because I had thought of that same answer as well as also because I thought of the same mythbusting. But I was lacking ganas.

jlliagre

@tchrist Tuve la ganas.

tchrist

^las, or else I'll get confused thinking it's two smashed together independent clauses: Tuve yo + La ganas tú. Well unless that's what you meant. :)

jlliagre

@tchrist You were lacking ganas but fortunately I got them.

tchrist

02:33

Indeed.

We used to use ganas in English back when I was in a code-switching community.

Well, or in Spenglish or whatever you call that mélange.

And lots of calques, like when something didn't appetesce us.

> Circius et boreus, twegen norðwindas.

jlliagre

> In un placete de La Mancha of which nombre no quiero remembrearme, vivía, not so long ago, uno de esos gentlemen who always tienen una lanza in the rack, una buckler antigua, a skinny caballo y un grayhound para el chase. A cazuela with más beef than mutón, carne choppeada para la dinner, un omelet pa’ los Sábados, lentil pa’ los Viernes, y algún pigeon como delicacy especial pa’ los Domingos, consumían tres cuarers de su income.

tchrist

I knew not that they were a twain.

@jlliagre That's hilarious! It's impossible to say cuarers. :)

jlliagre

It's funny that I wrote bullshit in my reply while I wanted to write bollocks.

HippoSawrUs

05:33

@M.A.R. It's actually filth, and they're sorry. You can go to the water dept. and get some kind of cleaner if it stained anything, like tubs and clothes, I think. People just do not care; weird.

Well, I have a teaching job for every old person who'd like a little extra income: Handwriting for Communication and Cognitive Skills.

Yep, it's official. Generation Z doesn't know how to handwrite, and think at the same time, so they're becoming stupid.

They increasingly can't write long sentences.

They can't have abbreviated conversations, because they can't think of long conversations; short retorts are all they've got.

They're not being short with you; they are short.

So rich busy parents can pay you to teach their children how to handwrite more complex sentences and form a somewhat cohesive paragraph.

I would charge as much as I could get away with. Remember to use the words Communication and Cognition.

Nobody wants a teenager who passes out after 5 real words in succession.

You can do it.

Go out and make that dough, brother.

Your roof is old and lumber ain't cheap.

alphabet

05:52

@HippoSawrUs You're in the US, right? I'm always shocked to hear when people have water quality that bad.

HippoSawrUs

Women, make your man a Communication & Cognition Center in the house somewhere.

Nobody listens to women yet, maybe later.

alphabet

@HippoSawrUs ainnobody need that, we got chatgpt now

HippoSawrUs

@alphabet Yes, in a city you've heard of, I'm sure. IDK what's wrong with this town.

@alphabet Yeah, they're like AI but more surface smart and indepth dumb.

When my slowish sister couldn't guess right or grasp something, she pretended not to care. I would say, 'You can look it up in the World Encyclopedia if you don't believe me.' And she would just walk out of the room.

She became an English teacher. Yep.

That sort of dismissal has been around a long time.

People know it's lack of smarts, not consideration or time.

But Gen Z thinks they invented it: Wait, let me swipe my thumb three times…nope, it's not a thing.

World Book Encyclopedia

alphabet

06:08

In fact: imagine having to pay for water. (My apartment building is old enough that they don't have separate meters; they couldn't bill us even if they wanted to.)

HippoSawrUs

@alphabet I had an all-bills-paid apartment once, around 1990, $400 even. I had the coldest apt in TX, I can tell you that.

Every summer day they had a death count, by falling alseep in the sun.

Don't lay out in the sun if you've never seen a treeline; that's what I always say, but no…

They couldn't help themselves… Texas.

Some things are inevitable.

alphabet

@HippoSawrUs At first I thought: wait, you mean hottest? Then I realized that, in Texas, presumably you spend a lot more on cooling.

HippoSawrUs

We had rusty water for years because nobody knew how to flush the well after Papa died.

alphabet

With well water it is a bit more expected.

HippoSawrUs

Ever since then I would pay $100/mo for clean water, whatever it costs, but somehow I'm stuck here with this mess, not in TX or NC anymore, in GA. These people…vary a lot. Very kind or you want to back over them.

alphabet

06:19

To be fair, I don't actually know how much heat, water, and hot water cost.

HippoSawrUs

Have to stay in the city

alphabet

@HippoSawrUs Yes, the rest of Georgia can be...East Alabama.

HippoSawrUs

It depends on how much you use and where you are. It's cheaper to live in the rural SE USA.

OMG, I lived in AL before. They put white balloons on their mailboxes for Klan meetings.

alphabet

I recently met someone who moved here from Alabama after she got fired from her job for being a lesbian.

HippoSawrUs

But Panama City Beach was nice, not far away.

alphabet

06:24

She could have sued, of course, but given the amount of time and money involved, it wasn't worth it.

HippoSawrUs

@alphabet Sometimes it's just best to run from a volcano of hate. Nobody has enough time and energy to fix that d@mn place.

alphabet

@HippoSawrUs Yes, getting fired from your job is one of many reasons one might not want to be a lesbian in Alabama.

HippoSawrUs

You don't want to be anything in AL

alphabet

I wouldn't even want to be a raccoon there.

HippoSawrUs

Especially a woman with a baby carriage crossing the street with a Puerto Rican man

alphabet

06:31

Eat trash there, you'll die of diabetes at age 2.

HippoSawrUs

Two white young men in a truck swearved closs to scare us and yelled: 'Get out the street with your colored baby!'

alphabet

@HippoSawrUs Wait, that actually happened to you?

People are bad.

All of them.

Especially men.

HippoSawrUs

He was our best friend, on the way to pick up my baby's father, a French/Greek/Italian/Californian man.

alphabet

Imagine seeing this friendly youngster and wanting to hunt him down and kill him for sport, like they do in Alabama. Also everywhere else, but especially Alabama.

Ethnic cleansing, that's what it is.

HippoSawrUs

Some people in AL were very nice, well educated, but they had segregated stores in the '90s. WTH?

Hopefully, it is better now. But I'm not dying there. I'm just hiding in my old age; that's it.

@alphabet Cute pic. I have a racoon pillow buddy pattern. I think I'm going to make mine in shades of violet.

Raccoon, I meant

@alphabet Yes, they had no idea that the baby's great-grandmother was a racist, former Australian debutante who still called people "Aboes"…in America.

So we never visited her. Just let her die in peace, alone.

I don't know where she came from, never claimed her.

@CowperKettle I remember when my hometown had around 3500 people. It seemed like a lot then. I was like, 'What! Where are all these people?' :-)

HippoSawrUs

07:44

Wait, OPs don't know the word "resist"?

What about "stop"?

What will they do a policeman tries to pull them over?

They'll just keep going and get arrested for continuing…

Because we can't be enroute to everywhere

One man's police halt is another man's end of endeavor

Where is all this pausing and unpausing leading to anyway?

do if a policeman

Meh

Xanne

09:54

Connections
Puzzle #600
🟩🟦🟦🟦
🟩🟦🟦🟦
🟨🟨🟨🟨
🟩🟩🟩🟩
🟦🟦🟦🟦
🟪🟪🟪🟪

Strands #334
“Baby talk”
💡🔵🔵💡
🔵🟡🔵🔵
🔵🔵🔵

Xanne

10:06

Wordle 1,322 3/6

🟨⬜🟨⬜⬜
🟨⬜⬜🟨⬜
🟩🟩🟩🟩🟩

M.A.R.

10:19

@Mitch aspirin is very old. There's no reason in this day and age to use aspirin for fever or headaches, because the dose required to achieve the same response as NSAIDs is very high (around 600). And you're not getting a Toyota, I have spoken

Aspirin is cardioprotective, but even at doses of 80-100 mg, a doctor should prescribe it, since its benefit to your heart must outweigh the danger it poses to your stomach

SmokeDetector

13:11

[ SmokeDetector | MS ] Manually reported question (93): Restive and restful‭ by Egg Puff‭ on english.SE

tchrist

@HippoSawrUs The only birds you'll ever catch laying out in the sun within eyeshot of timberline are ptarmigan, where there's so little air that the sun fondly kisses their eggs with praeternatural affection. Lower birds lay theirs in the coolth of nests nestled 'neath the leafy canopy where the sun doesn't shine.

> Herman Melville captured, without endorsing, the nationalist fervor
in his novel “White Jacket”: “We Americans are the peculiar, chosen
people — the Israel of our time. God has predestinated, mankind
expects, great things from our race; and great things we feel in
our souls.” Walt Whitman joined the chorus: “Have the elder races
halted? / Do they droop and end their lesson, wearied over there
beyond the seas? / We take up the task eternal.” There’s no confidence
like adolescent confidence, for a person or a country.

More teenager troubles.

"There’s no confidence like adolescent confidence, for a person or a country."

tchrist

13:36

@HippoSawrUs That's because the United Nations Security Council never fully authorized the bombing out of existence of all the Al-Abama–backed militant terrorist training camps down there in that hot mess.

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