Podcasts about Tramadol

This week, we cover a range of topics: urinary vs cervical HPV collection, the benefits and harms of Tramadol, whether patients need anticoagulation after successful ablation for afib, and the ongoing value of COVID vaccines in the omicron era. Plus a quiz: is TAVR now indicated for everyone with severe aortic stenosis? Stay tuned!

A Knee Recovery Nightmare! Right Total Knee Replacement My Physical and Emotional Fight Against Pain Hypersensitivity and Protective Muscle Guarding – written by Cathy Banovac – interview by Lisa Pelley and Mary Elliott – Cathy was coached by Erin Rempher, PTA My name is Cathy and I reside in Arizona. I am 57 years old, a homemaker, and have had a genetic history of chronic osteoarthritis.  From a very young age, I have always had a very low pain threshold.  Prior to the commencement of pain in my knee, I considered myself a fairly fit and active person…loved gardening, entertaining family and friends, cooking, crafting, playing golf, traveling with my husband, walking our dogs, and playing with our grandchildren. Life was good! Early Summer In addition to the normal aches and pains that come with aging, I began to experience more than usual pain in my right knee.  I was experiencing daily occurrences of popping/clicking, giving out when walking at times, difficulty negotiating steps or stairs, and nightly interrupted sleep due to pain.  Over the counter medications, icing, heat, etc. was no longer managing my symptoms.  Upon visiting an orthopedic surgeon for examination and subsequent imaging, I learned I was over 70% bone on bone in my right knee joint.  I was told I was looking at a total knee replacement.  I was preparing to head to Michigan for a family vacation on the lake with my kiddos in August, so was not happy to hear this news.  I convinced my doctor to give me a steroid injection just to buy me the time I needed to take my vacation.  He was reluctant and told me that he predicted it would do nothing to help my condition at the very least or, at the very most, last for a brief time.  I made it through the trip, yet 3 weeks post-injection the symptoms had returned. No More Injections My surgeon declined my request for another injection, instead reiterating my need for the TKR.  Over previous years, I had witnessed my mother, father, husband and a few friends have knee replacement surgeries.  All came through their surgeries with what appeared to me to be a fairly pain controlled, timely recovery and successful return to their regular daily activities.  I was told I was on the younger side for this type of procedure, nevertheless, would greatly benefit from extended quality of life and return to desired activity, given my current quality of life and daily activity was becoming more diminished by the day. My Knee Replacement I underwent RTKR on September 25.  All went well and as expected with the surgery.  I was up and walking, began some light physical therapy exercises, and maintained post-op range and motion through use of a CPM while in hospital.  I was discharged to home on the third day post-op, with a couple of narcotic pain medications (initially Percocet/Oxycodone and Morphine) and directions to commence in-home physical therapy the following day.  My follow-up visit with the surgeon was scheduled for 6 weeks post-op.  Day one at home began my challenging journey of recovery, both physically and emotionally.  I experienced difficulty managing my pain even with narcotics and over the counter medications.  My swelling was as expected and able to be kept in check with anti-inflammatory meds and icing.  I experienced annoying side effects from the narcotics, i.e., headaches, nausea, constipation, and thus was bounced from one medication and dosage to another, none of which seemed to be the right combination or solution to my pain.  Out of complete desperation and in uncontrollable pain, I went to the emergency room after being home for four days post-op, hoping to get some relief. A Problem with the Surgery? I thought surely there must be something wrong.  A few hours later, together with a lecture from the hospital PT and some morphine, I was discharged back to home.  Back on more medication, I failed to again find relief from pain.  I was averaging about 2-3 hours of sleep per night and little sleep during the day.  My home physical therapist had her work cut out for her.  Over the next 4 weeks (twelve 45 min. sessions of in-home PT), I had yet to reach better than 85 degrees flexion and 10 degrees extension.  My in-home therapist said she spent most of those 4 weeks strengthening my calves, hamstrings, and quad muscles, all which were extremely weak.  Therefore, already I was approximately 4 weeks behind in range and motion advancement.  My pain was still very much out of control, all while I feared becoming more and more dependent on the narcotics prescribed. At the first follow-up appointment (six weeks post-op), my flexion was below 90 degrees and extension still not at the zero degree mark.  I was informed by my surgeon that I needed a Manipulation Under Anesthesia (MUA).  My knee felt very stiff, pain was still unmanageable, and I was stuck without advancement in physical therapy. Manipulation Under Anesthesia He took x-rays and made sure the appliance was not loose or slipping out of placement.  All was found to be in proper order and an examination found no infection that could be causing pain or other symptoms.  My surgeon had done his job.  I was told however, that he believed I was stuck due to scar tissue build-up and thus was in need of the MUA to break up the scar tissue.  This would also permit the ability to continue physical therapy, working towards achievement of the desirable degree of range and motion outcomes.  I underwent the MUA six weeks and one day post-op and immediately resumed PT the following day.  I was told not to worry about a reduction in my flexion and extension after having the MUA.  An MUA tends to put patients back about 3-4 weeks, so it is almost like starting all over again.  However, the idea is that advancement in range and motion should become easier now that the scar tissue has been broken up by the procedure.  I went to PT for 5 days in a row the first week following the MUA, did my home exercises faithfully on my own twice a day, then returned to PT three times a week for the next several weeks. After the MUA At the two week follow-up appointment post the MUA, I was still in unmanageable pain, still getting only 2-3 hours of uninterrupted sleep per night, and running every gamut of emotion and temperament.  My poor husband was beside himself and wondering whatever became of the woman he married 27 years ago.  My flexion was still only reaching in the low 90's and my extension was no better either.  I was still experiencing great sensitivity to the touch anywhere on or around my surgical knee.  I couldn't stand wearing pants or having any sheet or blanket covering my knee.  My pain was the worst at night, just when I was settling in for some restful moments on the couch watching TV with my husband.  I would suddenly be lifted off my seat with either pain that mimicked touching a lit match to my knee, or the stabbing of a knife, or the shock of a taser. Dealing with the Pain This pain varied and sometimes was relentless for several minutes.  I was in tears most evenings and headed to bed to ice or apply heat, which calmed the nerve pain somewhat.  I would take meds (Hydrocodone/Norco, Extra-Strength Tylenol, Ibuprofen,  Zofran (for nausea) Vitamins, a stool softener (due to Hydrocodone) and Gabapentin aka Neurontin.  I was soooo sick of taking medications.  I think my surgeon was beside himself as to how to control my pain and sensitivity, therefore, he recommended I seek help at a Pain Management Clinic for possible sympathetic blocks, as well as my medicinal pain management.  Both he and my physical therapist told me I was forecasting pain neurologically before any exerted physical effort on their part was made to cause any pain.  My intolerance for any amount of pain was prohibiting any measurable progress in my range and motion, thus scar tissue was building at a rapid pace.  Physical therapy continued to be a challenge as I protective muscle guarded any force applied by my therapist to get better R&M.  I cried through most of my sessions. Pain Management At my first appointment with the Pain Management Clinic, I met with the doctor.  Most people have sympathetic blocks in their back to relieve nerve pain, but the doctor I was referred to chose to recommend a Genicular Neurotomy, accomplished through a procedure called Coolief Cooled Radiofrequency Ablation.  I first underwent a test which involved Lidocaine injections in four areas surrounding my new knee.  The patient then logs their pain and activities over the following 72 hours.  A follow-up appointment with a Nurse Practitioner then reviews the log and determines eligibility for the ablation procedure.  At this appointment she chose to cut my medication cold-turkey for a couple of days as she deemed I was dependent on them, even though I was getting little pain control.  I experienced severe withdrawal symptoms for two days. A Change in Medication I thought I was going to go out of my mind.  A change in my medication increased the Gabapentin I was taking, and I was found to be eligible for the ablation.  I underwent that procedure approximately 6 weeks post my first MUA, just before the Thanksgiving holiday.  I was told that I would still be experiencing pain for approximately 4-6 weeks, due to the fact that the ablation was going to make my nerves “angry” as they fought their temporary death.  I was also informed that this procedure is temporary as nerve endings most often regenerate themselves over a 6 month to 2 year period.  Some patients must undergo two or three of these procedures to get lasting relief. Unhappy News This was not happy news to my ears, yet I was still desperate for relief and reaching out for anything, and I mean anything, that would control my pain.  I returned to the pain clinic for a follow-up to the ablation procedure only to report pain still very bad and that I was still taking a boatload of medication, icing, heat to quad muscles to relieve cramping, and poor results in physical therapy sessions.  I was told to give it more time and come back in a few more weeks.   At my next follow-up approximately 3 weeks later, I discharged myself from the Pain Management Clinic.  I felt that their treatment plan was not successful for me and they had no other plan to offer other than continued reliance on prescription medication and time. When recovery goes wrong – Read More A Desparate Time After barely getting through the Christmas holidays, persisting in physical therapy and weaning myself down on prescription medications (since they didn't seem to be having any great effect on my pain), I began to explore the possibility of medical marijuana as a solution to my pain control.  I have never tried marijuana and had little desire to smoke or vape it, but was interested in edibles they have out now.  I was desperate and finding myself sinking into anxiety, panic attacks and, at times, depression.  My family and my husband were becoming very concerned as I was changing into a person they did not know and they were at a loss as how to help me through my circumstances. Medical Marijuana Since medical marijuana is legal in the State of Arizona, I sought out a doctor with whom I met and applied for a patient card.  This process took approximately 3 weeks, including approval of my application through the Arizona Department of Health and Human Services.  Upon receiving my card, I met with a licensed nurse at a dispensary to become educated about the various products and my specific needs.  She was recommended by the doctor who signed off on my patient eligibility and works with a number of cancer patients to help control their symptoms.  We met for over an hour.  She was extremely patient with me, educating me about cannabis (which I knew little of) and gave me recommendations to try.  I purchased three of her recommendations.  I also decided to try getting a light massage once per week.  The massages lasted for approximately three weeks before I decided to suspend them, as I found them not helpful enough to warrant the expense. Little if Any Improvement Having done everything I was asked to do in my recovery and still making little if any gains, I found myself in a very dark place emotionally, desperate to end my pain, and I was done!!  One day, I was occupying my time, in between home therapy and out-patient therapy sessions, searching the Internet for anything that might literally save me.  When in answer to my prayer, I came across several website postings about a therapy called X10.  I shared some of it with my husband, my parents and my kids.  They encouraged me to explore it more.  After reading some of the patient blogs and watching a few of the videos that I could access, I made my first contact with PJ Ewing by emailing him.  PJ responded very quickly telling me that the X10 Therapy and machine was not yet available in the State of Arizona, but he provided me with some other resources.  I was initially devastated by this news, but I almost immediately decided that I was not going to accept that response.  I instantly thought to myself, “Well, if it is not available in AZ, then maybe I can travel to wherever it is available. Not Taking ‘No’ for an Answer This time, I placed a phone call to PJ and we talked for over an hour.  As it so happened, in our conversation I discovered that the X10 headquarters is in Franklin, MI, and I had family who lived in Rochester, MI.  PJ was more than gracious in discussing all the parameters and specifics of the possibility of travel to Michigan to undergo the X10 program.  To say the least, after completion of my discussion with PJ, I heard God say “Not yet, Cathy, I still have a plan for you on this earth.”  I discussed the possibilities with my husband and shared them also with my son and daughter-in-law, exploring their permission to have me as a houseguest for 2-3 weeks.  Of course, they couldn't have been more gracious and welcoming. Pain Still a Big Problem My pain was still out of control, I continued out patient PT three times a week with slow or little advancement in my R&M, had my six week MUA follow-up with my surgeon only to be told I was facing a second MUA.  I told my surgeon and my physical therapist about the X10 Therapy website I had discovered, and PJ sent me the clinical data to share with them.  Each of them, I am grateful to say, told me they had looked at the data and were “intrigued” by the therapy plan.  Both encouraged me to pursue it as an option for me, yet both also strongly indicated that enough time had passed between my first MUA and the ablation, therefore, still recommended I have the second MUA before commencing X10 Therapy. Turning to X10 Therapy after a Second MUA Once my husband and I had made the decision to pursue this plan, the wheels began to roll quickly.  Initially, I scheduled the 2nd MUA and a flight out from Phoenix to Detroit by myself the next day following the MUA.  I notified PJ of my  plans and he began to put things in motion by placing me in contact with Mary Elliott, Melissa, Mike, a therapy Coach, Erin a Physical Therapist, and Marty, a technician for machine home delivery and set-up.  The X10 Therapy approach is really a “team” approach to wellness, in addition to the machine itself and the technological programs it delivers to the patient. The Second MUA Was Coming Up As the days approached the 2nd MUA, I became extremely anxious and experienced a couple of panic attacks.  I began to stress about the MUA pain, having gone through one already.  The thought of flying alone, even though my son would be there to meet me at the other end of my flight, and having to get through a 4 hour flight plus 1 hour car ride to his home in pain, had me scared beyond belief.  I was consumed with thinking about how I would manage my pain.  Should I just knock myself out to sleep on the plane?  What if that didn't work?  What meds could I then take if in pain?  What about my leg position – straightening and bending?  How would I get help from curb, through security, to gate, onto plane and the same again when arriving including a stop at baggage claim?  How am I going to sleep at night?  Is this therapy going to put me back in unmanageable pain again, even though the X10 Therapy information says I am in control?  What if it doesn't work?  Can this end my knee recovery nightmare? And on and on and on…! Making Plans After talking it over with my husband and doctor, it was decided that I would delay my trip to Michigan for one week following the 2nd MUA.  I would continue outpatient PT immediately following the MUA, but have some time to consult with a psychologist concerning my sleep depravation, fears, anxiety/depression and develop a plan to manage my pain, as well as talk to the airline for special assistance to help solve my transportation needs.  My husband decided to make the trip with me for a couple of days, just to get me settled and started with X10 Therapy.  Armed with a revised medication and travel plan, I notified the X10 Team of my change in start date and all were extremely understanding and accommodating.  I had the 2nd MUA  on January 18.  I continued outpatient PT for three more sessions, in addition to my own home exercises twice per day.  My daily sleep and pain control was managed better and I was counting the days until our departure date.  It simply could not arrive fast enough! Friday, January 19 This will remain a very important and pivotable day in my life.  My journey towards healing, life anew and well-being would begin that very day.  Having endured a comfortable flight and having managed all the transportation arrangements with ease (kudos to Delta Airlines), we arrived at my son's home ready to commence what I can now claim as my own personal miracle.  Within an hour, Marty arrived with a smile, this technological marvel known as the X10 machine, and a thorough first orientation/training session filled with words of encouragement and confidence.  I was on my way, although until I began to see results (which were really displayed within that first session), I Had Hope I was still cautiously optimistic about where I was headed.  Could I really achieve the flexion and extension goals I was unable to achieve thus far with any of my existing recovery methods?  Would this therapy really enable me to manage my pain comfortably with mild medications?  Could I trust my X10 therapist and her plan for me?  Would the X10 team really be there for me when I needed them?  Was the X10 therapy the answer to my prayers?  Would I really be returning home in as little as  just over 2 weeks time to see my surgeon's and physical therapist's jaws drop as they witnessed my flexion and extension reach what we all thought would be skeptical results, but instead blow them away with incredible success?  It would not be long before I could actually acknowledge to myself that the answers to each of those questions would be a resounding YES! 110º Flexion Once I was able to reach the 110 degree mark for flexion, it was decided that I would add 5 min a day on the stationery bike. As I felt comfortable, I was able to increase that time in small increments and add another bike session in the evening.  While my progress was measurable daily, I did experience some cramping in my right thigh and calf, dealt with some bursitis in my right hip for about two weeks, and waking with some right leg pain some nights. Taking Care of Myself I found icing and elevating regularly after each exercise session, icing my hip, heat on my upper thigh at night, Tramadol 50 mg. only twice a day with Ibuprofen and Acetaminophen alternated during the day, and Theraworx Relief foam massaged in the cramping areas once or twice a day helped keep my discomfort manageable.  In addition, I spent some resting time researching dietary recommendations for inflammation and pain.  I incorporated tumeric, magnesium, Osteo Bi-flex, 100% Cherry or Pineapple Juice, Vitamin B6 & B12, Vitamin C, Vitamin D3, Zinc, fresh berries and decaffeinated tea with ginger, lemon and honey in my daily diet.  I also decided to limit carbohydrates and sugar intake in an effort to keep my inflammatory response in check. One Week In After one week on the X10 and with constant reassurance and communication from all of my X10 team, I could actually begin to call this journey and the X10 Therapy my miracle.  I had breached the 100's for flexion after starting at 55 degrees, and reached 0 degrees at the end of the first session on my extension, previously at 8 degrees.  My fears, anxiety and uncertainty soon gave way to renewed love for life, joy at gaining confidence in doing daily activities again, sharing my daily success by telephone with family and friends, and hope for the future.  The almost daily contact from one or more of my X10 team members answered any questions that arose, provided authentic cheerleading for my cause, and motivated me to press on for better and better results. Working with My Coach Mary called often to check in with me and was my calm and steady encourager.  My conversations with her were uplifting and kind of like talking to an old friend, casual and comforting.  My PT, Erin, made a home visit to discuss my history and offered varied strategies for increasing my flexion degrees, as well as made adjustments in my therapy plan due to some bursitis that I had recently developed in my right hip.  She was careful to make the appropriate adjustments to my therapy plan.  She and Mike (my strengthening coach and with whom I also met in person to go over exercises), together modified my plan by delaying some of the exercises, while still permitting three sessions a day for range and motion growth. Conclusions As I approach my last day of sessions on the X10 Therapy machine and a return home to Arizona tomorrow, I write my story to encourage anyone who has experienced one or more of the circumstances that I experienced subsequent to a total knee replacement.  I am happy to report that I was successful in breaking through some of my scar tissue, reaching 0 degrees for my extension and 117 degrees flexion.  My gait is much improved and, as I have returned to walking without a limp or dragging my surgical leg, the pain in my hip and lower back has also improved greatly. My knee recovery nightmare has finally come to an end. Some Rehab Insurance I will continue outpatient therapy immediately upon my return home in order to solidify my current range and motion, and even further improve my flexion as I am able.  I write this also as a means of paying it forward to future patients of the X10 and in grateful appreciation to my X10 Team, my family and my friends who affirmed, guided, encouraged, and yes, celebrated, my X10 Therapy journey of success.  The proof, as they say, is in the pudding, which is said to mean that you can only judge the quality of something after you have tried, used, or experienced it.  I absolutely cannot wait to share my experience and demonstrate my range and motion achievement in person to my surgeon and PT Team back home in Arizona. Thanks be to my God, to all of my support team and to X10 Therapy… life is good once again! To read about total knee replacement for a younger population, click here. The X10 Meta-Blog We call it a “Meta-Blog” because we step back and give you a broad perspective on all aspects of knee health, surgery and recovery. In this one-of-a-kind blog we gather together great thinkers, doers, writers related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. Whether you have a surgery upcoming, in the rear-view mirror, or just want to take care of your knees to avoid surgery, you should find some value here. #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }/* Add your own MailChimp form style overrides in your site stylesheet or in this style block.We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */ Subscribe to the Blog Here * indicates required Email Address * First Name Last Name

Tramadol is widely prescribed for chronic pain because it's perceived as "safer" than other opioids but more effective than other over-the-counter pain relievers, yet newer evidence challenges both its effectiveness and long-term safety A 2025 BMJ Evidence-Based Medicine analysis found tramadol reduced pain by less than one point on a 10-point scale, a change unlikely to meaningfully improve daily function The same analysis linked tramadol to more than double the risk of serious adverse events, including cardiovascular complications, while also causing frequent side effects that disrupt normal activity Beyond health risks, opioid medications like tramadol impair driving ability and have been increasingly detected in fatal car crashes, contributing to roadway deaths even when taken as prescribed Safer pain management focuses on nondrug strategies such as acupuncture, physical therapy, massage, targeted nutrition, and stress reduction, which address pain drivers without exposing you to opioid-related harm

Alors que l'errance médicale représentait pour Gala une période d'espoir, l'annonce du diagnostic provoque une fracture profonde. Ses douleurs, jusque-là considérées comme « bénignes », deviennent chroniques.

Contributor: Taylor Lynch, MD Educational Pearls: What is tramadol and how does it work? Tramadol is a Schedule IV opioid analgesic used for moderate pain and is often perceived as safer than other opioids due to lower abuse potential. It is a prodrug with weak direct μ-opioid receptor activity. The parent compound also inhibits serotonin and norepinephrine reuptake, giving it SSRI/SNRI-like properties. Tramadol is metabolized by CYP2D6 into O-desmethyltramadol (ODT), which has significantly stronger μ-opioid receptor agonism than the parent drug. What are the concerns with tramadol? Ultrarapid CYP2D6 metabolizers (more common in Middle Eastern and North African populations) rapidly convert tramadol to ODT, increasing the risk of opioid toxicity. Poor CYP2D6 metabolizers generate little ODT and may experience primarily serotonergic effects, increasing the risk of serotonin syndrome, especially when combined with SSRIs or SNRIs. CYP2D6 inhibitors (e.g., bupropion, paroxetine, terbinafine, celecoxib) can block tramadol's conversion to ODT, potentially precipitating opioid withdrawal or increasing serotonergic toxicity. Tramadol is also associated with an increased risk of first-time seizures, even at therapeutic doses. Key takeaways Tramadol's effects are highly unpredictable, varying from minimal analgesia to exaggerated opioid effects depending on metabolism. Drug–drug interactions can lead to serotonin syndrome or opioid withdrawal. Despite its Schedule IV classification and reputation for safety, alternative analgesics may be preferable in many patients. References DailyMed - TRAMADOL HYDROCHLORIDE tablet, coated. Accessed January 10, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=61fb5ba7-6896-4ee4-83de-caee69b06a8e#ID57 Dean L, Kane M. Tramadol Therapy and CYP2D6 Genotype. In: Pratt VM, Scott SA, Pirmohamed M, Esquivel B, Kattman BL, Malheiro AJ, eds. Medical Genetics Summaries. National Center for Biotechnology Information (US); 2012. Accessed January 10, 2026. http://www.ncbi.nlm.nih.gov/books/NBK315950/ Aly SM, Tartar O, Sabaouni N, Hennart B, Gaulier JM, Allorge D. Tramadol-Related Deaths: Genetic Analysis in Relation to Metabolic Ratios. J Anal Toxicol. 2022;46(7):791-796. doi:10.1093/jat/bkab096 Summarized and edited by Dan Orbidan OMS2 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf  

Controvérsias, vantagens, experiência clínica e oque dizem os estudos: isso tudo faz parte da conversa com a Dra. Sandra Mastrocinque, médica veterinária e colaboradora do Vetsapiens. Dra. Sandra MastrocinqueMestrado e Doutorado em Anestesiologia na Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo (FMVZ/USP). Atualmente é coordenadora de anestesiaem alguns Centros Cirúrgicos em Ribeirão Preto, e realiza estudo de eficácia clínica de analgésico em cães. Ministra aula em diversos eventos e cursos de anestesiologia e analgesia veterinárias. Autora de artigos e capítulos sobredor e anestesiologia veterinária. Membro do Comitê da Veterinária da Sociedade Brasileira da Dor e é colaboradora do Vetsapiens. Conecte-se com o Vetsapiens!www.vetsapiens.com https://www.facebook.com/vetsapienshttps://www.instagram.com/vetsapiens/

Zeena a eu ses premières règles à 6 ans, en CP. Elle nous raconte comment cette puberté précoce a marqué son enfance et l'a rendue addict au Tramadol. Hébergé par Audion. Visitez https://www.audion.fm/fr/privacy-policy pour plus d'informations.

On today's Good Day Health Show - ON DEMAND…Host Doug Stephan and Dr. Ken Kronhaus of Lake Cardiology (352-735-1400) cover a number of topics affecting our health. First up, Doug and Dr. Ken discuss the biggest news stories in the medical world, starting with a focus on Tramadol and the risks associated with the opioid painkiller, used to treat moderate to severe pain in adults.Next up, the discussion shifts to Repatha, a prescription cholesterol medication, and the conflicting information coming out about cholesterol based on outdated research. Continuing on the drug discussions, the FDA has approved a new drug, Jascayd, used to treat adults with Idiopathic Pulmonary Fibrosis — a chronic progressive, and usually fatal, lung disease. While most may think of Botox as only a cosmetic injectable, it's also a medication. New research has found Botox to demonstrate statistically significant improvement in reducing the disability from the movement disorder associated with upper limb essential tremor compared to placebo.A continued focus on alcohol consumption and that even light alcohol consumption can still cause damage to the brain with risk levels of dementia rising with a link between alcohol consumption and negative cognitive outcome.Over the years, there has been research on symptoms of long-Covid, specifically brain fog — the inability to think as well as you did in the past — with advanced imaging showing widespread increase in the density of AMPA-receptors in the brains of long-Covid patients who suffer from brain fog.Rounding out the program, Doug and Dr. Ken address the government shut down and how it affects medical care. Currently, there isn't a great effect on the local basis, but the FDA is not currently approving new drugs or more new research grants during the shut down. Lastly, what it means when you have a good night's sleep and wake up feeling exhausted still, felling unrested.Website: GoodDayHealthrShow.com Social Media: @GoodDayNetworks

Nouvelle diffusion du 7 juin 2025 Thierry a développé une dépendance à cet antidouleur à base dʹopioïdes après deux opérations et un accident. Il en a pris pendant plusieurs mois et nʹarrivait pas à arrêter. Il raconte à Isabelle Fiaux comment il est finalement parvenu à sʹen défaire.

There's concerns tramadol could be getting over-prescribed, with more patients being given the painkiller. Pharmac data shows more than 270,000 people were prescribed the drug last year - an increase of 14 percent since 2019. UOA School of Pharmacy lecturer Dr Jay Gong says healthcare providers likely prefer prescribing tramadol over stronger painkillers. "There might be some perceived ideas around it - because it's a weaker opioid, it's maybe not as addictive and maybe in the long run, you might not have as much side effects." LISTEN ABOVESee omnystudio.com/listener for privacy information.

On the Heather du Plessis-Allan Drive Full Show Podcast for Thursday, 2 October 2025, three New Zealand citizens have been arrested by the Israeli Defence Force because they were on a protest flotilla headed for Gaza. One of them is 18-year old Samuel Leason, his dad speaks to Heather. The Warehouse chief executive Mark Stirton tells Heather why the company is struggling to turn a corner. What's behind the rise in Tramadol prescriptions? Should we be worried about people getting addicted to pain killers? More drama in the Maori Party with the very public falling out between the party leadership and the leader of Toitu Te Tiriti. Plus, the Huddle gets fiery after Wayne Brown tells an Auckland Ratepayers group to "f off". Get the Heather du Plessis-Allan Drive Full Show Podcast every weekday evening on iHeartRadio, or wherever you get your podcasts. LISTEN ABOVESee omnystudio.com/listener for privacy information.

FIRST WITH YESTERDAY'S NEWS (highlights from Thursday on Newstalk ZB) Very Meme-able/More Wagging of the Dog/About Your Firetrucks.../Too Much Tramadol/Fresh FishSee omnystudio.com/listener for privacy information.

Folge 264: Benzydamin, Tramadol & neues Akne-Arzneimittel

Efter skilsmässan fungerade allt bra ett tag mellan Anna och Patrik. Men sedan hände något som fick Anna på riktigt dåligt humör... Idag berättar vi vad det var, och pratar också pengar och tramadol.Av och med Tobias Henricsson/PRS Media.Allt som sägs i podden går att styrka med dokument, inspelningar, skärmdumpar etc. Se www.prsmedia.se/granskning för att ta del av en del av dem.Har du information om det här ämnet? Tipsa oss på info@prsmedia.se eller via krypterad mail: prsmedia@protonmail.com.Studien om psykopati hos chefer hittar du här: https://pearl-hifi.com/11_Spirited_Growth/10_Health_Neg/08_Psychopathy_OPs_AFs/Snakes_in_Suits.pdfGlöm inte att sponsra oss på för att få fler och längre avsnitt! Gå in på patreon.com/krimmagasinet och donera en summa som podden får per månad. Till dig som inte stöttar på Patreon – tack för att du inte hoppar över reklamen! Inkomsterna från den är viktiga för att jag ska kunna jobba med just de här sakerna.Du kan också swisha ett engångsbidrag till nummer 123 356 17 01 (betalningsmottagare: Tobias Henricsson).Tipsa gärna vänner och bekanta om podden!Kontakt och sociala medier:https://www.facebook.com/prsmedia.sehttps://www.instagram.com/prsmediahttps://www.threads.net/@prsmediahttps://www.prsmedia.seinfo@prsmedia.se Hosted on Acast. See acast.com/privacy for more information.

Patriks dotter hamnar i ordentligt dåligt sällskap, och påträffas medvetslös av droger. Nu uppstår frågan: Om mamman är en så god vårdnadshavare, varför stoppade hon inte detta...?Av och med Tobias Henricsson/PRS Media. Ljudfiler från samtal spelas upp med tillstånd av Patrik Granevärn.Är du orolig för dotterns liv och hälsa och vill göra en orosanmälan? Gå in på https://www.prsmedia.se/oro så guidar vi dig rätt.Allt som sägs i podden går att styrka med dokument, inspelningar, skärmdumpar etc. Se www.prsmedia.se/granskning för att ta del av en del av dem.Har du information om det här ämnet? Tipsa oss på info@prsmedia.se eller via krypterad mail: prsmedia@protonmail.com.Glöm inte att sponsra oss på för att få fler och längre avsnitt! Gå in på patreon.com/krimmagasinet och donera en summa som podden får per månad. Till dig som inte stöttar på Patreon – tack för att du inte hoppar över reklamen! Inkomsterna från den är viktiga för att jag ska kunna jobba med just de här sakerna.Du kan också swisha ett engångsbidrag till nummer 123 356 17 01 (betalningsmottagare: Tobias Henricsson).Tipsa gärna vänner och bekanta om podden!Kontakt och sociala medier:https://www.facebook.com/prsmedia.sehttps://www.instagram.com/prsmediahttps://www.threads.net/@prsmediahttps://www.prsmedia.seinfo@prsmedia.se Hosted on Acast. See acast.com/privacy for more information.

Episode 88 – Serotonin Syndrome - What you need to know!   Serotonin Syndrome, also known as Serotonin Toxicity, is the most severe side effect of serotonergic medication and can potentially be fatal if not treated and managed. Therefore, understandably, many vets are very cautious when it comes to prescribing serotonergic agents and especially when combining serotonergic agents such as an SSRI and, for example, trazodone. ·         But, how frequent is this side effect in practice? ·         What are the signs you should be looking out for? ·         What can you teach your caregivers to do in terms of monitoring to screen for mild signs of Serotonin Syndrome? ·         What medications, aside from psychopharmaceutical medications, can cause Serotonin Syndrome? ·         What are the Differential Diagnoses for Serotonin Syndrome? ·         And how do you treat a pet with Serotonin Toxicity?   I talk about all this and more in this episode!   Here are the studies I mention in the episode: 1.      Indrawirawan, Y., & McAlees, T. (2014). Tramadol toxicity in a cat: Case report and literature review of serotonin syndrome. Journal of Feline Medicine and Surgery, 16(7), 572–578. https://doi.org/10.1177/1098612X14539088   2.      Pugh, C. M., Sweeney, J. T., Bloch, C. P., Lee, J. A., Johnson, J. A., & Hovda, L. R. (2013). Selective serotonin reuptake inhibitor (SSRI) toxicosis in cats: 33 cases (2004-2010). Journal of Veterinary Emergency and Critical Care, 23(5), 565–570. https://doi.org/10.1111/vec.12091   3.      Thomas, D. E., Lee, J. A., & Hovda, L. R. (2012). Retrospective evaluation of toxicosis from selective serotonin reuptake inhibitor antidepressants: 313 dogs (2005-2010). Journal of Veterinary Emergency and Critical Care, 22(6), 674–681. https://doi.org/10.1111/j.1476-4431.2012.00805.x   If you'd like to learn more about Veterinary Psychopharmacology, then my PSYCHOACTIVE course is for you! Follow the link below to get access to PSYCHOACTIVE – PRACTICAL VETERINARY PSYCHOPHARMACOLOGY Use SUMMER50 for a 50% Discount this summer 2025!   https://katrin-jahn.mykajabi.com/psychoactive   If you liked this episode of the show, The Pet Behaviour Chat, please LEAVE A 5-STAR REVIEW, like, share, and subscribe!   Facebook Group: Join The Veterinary Behaviour Community on Facebook   You can CONNECT with me: Website: Visit my website Trinity Veterinary Behaviour Instagram: Follow Trinity Veterinary Behaviour on Instagram Trinity Veterinary Behaviour Facebook: Join us on Trinity Veterinary Behaviour's Facebook page Trinity Veterinary Behaviour YouTube: Subscribe to Trinity Veterinary Behaviour on YouTube LinkedIn Profile: Connect with me on LinkedIn   Thank you for tuning in!

Thierry a développé une dépendance à cet antidouleur à base dʹopioïdes après deux opérations et un accident. Il en a pris pendant plusieurs mois et nʹarrivait pas à arrêter. Il raconte à Isabelle Fiaux comment il est finalement parvenu à sʹen défaire.

Victoria Bugtrup var 14 år, da hun første gang slugte en tramadol-pille, og det blev starten på et langvarigt misbrug, hvor hverdagen gik med at finde det næste fix.Tramadol er et stærkt, receptpligtigt opioid i familie med morfin, heroin og oxycodon, men Victoria havde ingen recept. I stedet stjal hun fra butikker for at skaffe penge til at købe stofferne på det sorte marked.Victoria er en del af den voksende gruppe af danske unge, der bliver afhængige af opioider. I dag er hun 17 år, har været clean i over et år og fortæller nu med sin mor, Pia Bugtrup, om misbruget og konsekvenserne for familien i håbet om, at andre i hendes situation søger hjælp i tide. Gæster: Victoria Bugtrup og Pia Bugtrup Vært: Jacob Grosen Tilrettelæggelse og klip: Mathias Bonde Foto: Joachim Ladefoged Denne episode blev bragt første gang d.13.03.25See omnystudio.com/listener for privacy information.

We're back and talking hardcore: - Hardcore trivia- Newerish stuff: Dynamite, Tramadol, Total Con- Poison Idea - Blank Blackout Vacant LP- Best Japanese Hardcore EPs 1981-1985 - Opening Round Part 2- Interview: Vinnie Stigma (Agnostic Front)Check the website for playlists, our links, and SMASH that Patreon button:https://185milessouth.comhttps://patreon.com/185milessouthWe are on Substack (sometimes) writing about punk and hardcore:https://185milessouth.substack.comGet at me: 185milessouth@gmail.comBuy Vinnie's book here: https://revhq.com/products/vinnie-stigma-the-most-interesting-man-in-the-world-bookIntro Song: Agnostic FrontOutro Song: Lip CreamSupport the show

Matt von Boecklin who for over a decade, traveled the world as a program evaluation specialist and chemical engineer, living in Asia, Africa, and South America.Along the way, he picked up a few bad habits, but now has quit his addictions to cigarettes, alcohol, Tramadol, and kratom. He works full time at Quit Kit, where he helps people suffering from addictions to kratom and opioids by offering a non-prescription way to relieve the severity of withdrawal symptoms.Main Business Issues:Internal struggles with people-pleasing, fear, and self-talkSelf doubt impacting Matt's business decisions Matt's Key Insights and Takeaways:Maintaining standards that align with realistic expectations is a challengeDeeper emotional work is necessary to elevate both personal growth and business performance.Connect with MattQuit Kit: https://tryquitkit.com/TikTok: https://www.tiktok.com/@the_quit_kit

Suspendu 25 matches sans salaire, Bobby Portis s'est trompé de médicament en confondant le Toradol et le Tramadol. Le premier étant autorisé, le second interdit. Son agent a parlé d'une « simple erreur commise en raison de la similitude des noms des médicaments et de leurs fonctions très similaires ». Il va donc falloir (quasiment) finir la saison régulière sans lui. Cette saison, Portis a une moyenne de 13,7 points par match avec les Bucks. Un coup dur pour les Bucks mais aussi une opportunité pour Kyle Kuzma, fraichement arrivé en échange de Khris Middleton et qui a là une opportunité de montrer son talent pour que Giannis Antetokounmpo et Damian Lillard leur accordent leur confiance en vue des échéances de fin de saison.Avec Jacques Monclar et Baptiste Denis.Jacques Monclar, Rémi Reverchon, Mary Patrux, Xavier Vaution, Fred Weis et Chris Singleton décryptent l'actualité de la NBA dans le Podcast NBA Extra. En complément de l'émission lancée en 2012, beIN SPORTS a créé, avec ce podcast, un nouveau format pour revenir en profondeur sur la ligue nord-américaine de basketball. Chaque semaine, les membres de l'émission débattent autour de trois thèmes majeurs, qui font l'actualité de la NBA.

Sandy Williams, the beloved guest host of Earl's Favorite, takes to the airwaves for a lively chat about Milwaukee Bucks sensation Bobby Portis, who has just been handed a hefty 25-game suspension. The NBA revealed that Portis tested positive for Tramadol, a painkiller that the league has banned, aligning with the World Anti-Doping Agency's list of prohibited substances. The conversation shifts to the weighty issue of Ukraine and its impact on American taxpayers. Earl and Sandy delve into the powers of the U.S. president, reflecting on how FDR's time in office led to the establishment of an eight-year term limit, curbing both presidential authority and duration. They discuss President Trump's aggressive stance towards Ukraine, suggesting he is pressuring the nation to relinquish its rights and potentially face conflict over territorial integrity. Despite the former president's previous support for Ukraine's resistance against Russia, the current narrative seems to echo Russian propaganda, with Trump allegedly demanding a significant portion of Ukraine's resources in a coercive maneuver. The Earl Ingram Show is a part of the Civic Media radio network and airs Monday through Friday from 8-10 am across the state. Subscribe to the podcast to be sure not to miss out on a single episode! To learn more about the show and all of the programming across the Civic Media network, head over to https://civicmedia.us/shows to see the entire broadcast line up. Follow the show on Facebook and X to keep up with Earl and the show! Guest: Sandy Williams

Sandy Williams, the beloved guest host of Earl's Favorite, takes to the airwaves for a lively chat about Milwaukee Bucks sensation Bobby Portis, who has just been handed a hefty 25-game suspension. The NBA revealed that Portis tested positive for Tramadol, a painkiller that the league has banned, aligning with the World Anti-Doping Agency's list of prohibited substances. The conversation shifts to the weighty issue of Ukraine and its impact on American taxpayers. Earl and Sandy delve into the powers of the U.S. president, reflecting on how FDR's time in office led to the establishment of an eight-year term limit, curbing both presidential authority and duration. They discuss President Trump's aggressive stance towards Ukraine, suggesting he is pressuring the nation to relinquish its rights and potentially face conflict over territorial integrity. Despite the former president's previous support for Ukraine's resistance against Russia, the current narrative seems to echo Russian propaganda, with Trump allegedly demanding a significant portion of Ukraine's resources in a coercive maneuver. The Earl Ingram Show is a part of the Civic Media radio network and airs Monday through Friday from 8-10 am across the state. Subscribe to the podcast to be sure not to miss out on a single episode! To learn more about the show and all of the programming across the Civic Media network, head over to https://civicmedia.us/shows to see the entire broadcast line up. Follow the show on Facebook and X to keep up with Earl and the show! Guest: Sandy Williams

Your Nightly Prayer

On this Real Life Pharmacology Podcast episode, we cover medications 181-185. Proscar is the brand name for finasteride. This medication can be helpful in shrinking the size of the prostate but it does typically take a while to work (months). Sinemet is a combination of carbidopa and levodopa. Levodopa is converted in the central nervous system to dopamine to help alleviate a shortage of dopamine in the brain. Risedronate is a bisphosphonate medication that can be used in the treatment of osteoporosis. Albuterol (Ventolin) is a short-acting beta-agonist that is used to relieve symptoms of acute respiratory distress most often associated with an asthma exacerbation. Tramadol is classified as an opioid analgesic. It also has activity similar to SNRIs as it has the ability to increase serotonin and norepinephrine in the brain.

Doggie Drive-Thru Amanda Brown opened a drive-thru fast food restaurant for dogs ONLY. Your dog can get the popular Bow Wow Bowl with their choice of protein, vegetables, or grains in an edible bowl. Bane and Vader's opened their flagship store in Easton, Pennsylvania. Amanda plans to franchise this idea, which came to her when she saw research showing that humans often ordered food for their dogs when going through a fast food drive-thru. Listen Now Microchips and Misconceptions While microchips are an essential part of pet identification, they will not help you find your missing pet unless it's picked up and scanned by a veterinarian or shelter. That's why Dr. Debbie recommends a visible tag and perhaps a GPS collar. Only a GPS collar will allow you to track your pet's location using your smart device or computer. Listen Now Shop Cats Do you know of a business that has a token cat? You'll certainly appreciate the "Shop Cats" in Tamar Arslanian's new book. She features the most notable shop cats in New York stores in pictures and written words. For instance, the wine store cat with his own chiropractor, the cat that is a mascot at a dog boutique, or the occult shop cat that totes a magic wand in her mouth. Listen Now Will There Be an Animal in the Whitehouse? A philanthropist wants to do something to make the Trump White House more like those in the past: She wants Donald Trump to have a presidential pet. The very wealthy Lois Pope, who is also the widow of National Enquirer founder Generoso Pope, announced that she was giving a ten-week-old golden retriever/poodle mix puppy to the Trumps. Listen Now Clothes Wearing Alligator Gets Pardoned Following months of negotiations with Florida state officials, Mary Thorn has been given a permit that will allow her to keep her pet alligator, Rambo, who she says is fully trained and not a "normal" gator. Mary dresses Rambo in human clothing to protect his sensitive skin. Listen Now Stealing Your Pet's Pain Killers Stealing from a sick animal may seem a low way to get a drug fix, but it happens frequently. Opioid abuse is rampant, and a survey from Baylor College of Medicine reveals a surprising number of pet owners steal their pets' medications, especially painkillers, namely the drug Tramadol. Listen Now App Replaces Trump Pictures with Kittens If you love animals, you should find this pretty amusing. Google now offers an extension for its Chrome browser called Make America Kittens Again. It replaces pictures of President-elect Donald Trump with adorable kittens. Listen Now Read more about this week's show.

En tidig morgon i januari 2024 rullar en lastbil av i Trelleborgs hamn den visar sig innehålla 740 000 narkotikaklassade tabletter. Det är tullens största enskilda beslag hittills av gängdrogen Tramadol. Lyssna på alla avsnitt i Sveriges Radio Play. ”När jag ser det här, så känner jag ju att pulsen går upp, hjärtat börjar slå lite extra”, det säger tullinspektören Victoria Malmström som var med när beslaget gjordes. Tramadol är ett narkotikaklassat läkemedel som tillhör gruppen opioider. Det togs fram av ett tyskt företag på 60-talet och kom sen ut på marknaden 1977. Tjugo år senare introducerades det på den svenska marknaden. Från början var Tramadol ett efterlängtat läkemedel, för patienter som behövde smärtstillande som var starkare än vanliga värktabletter men inte så starkt som exempelvis morfin. Men det visade sig vara långt ifrån problemfritt, flera år senare började läkare märka hur dödsfallen började öka och hur en del fick allvarliga biverkningar. ”Det är ett läkemedel som har två ansikten”, säger Kai Knudsen, överläkare och förgiftningsexpert vid Sahlgrenska universitetssjukhuset i Göteborg och förklarar att det både har en aktiverande och avslappnande effekt. På senare år har Tramadol också blivit känd som ”gängdrogen” – i flera av de mest uppmärksammade våldsdåden i de senaste årens gängkonflikter har utförarna varit påverkade av tramadol.”Om du tar den här tramadolen så kommer du må bra. Du kommer inte komma ihåg om du skjuter den här personen”, säger 22-årige ”Isak”, som använt Tramadol i flera år. Programledare: Petra Berggren och Linus LindahlProducent: Jenny HellströmReporter: David OhlssonLjudtekniker: Johan Hörnqvist Kontakt: p3krim@sverigesradio.seTipstelefon: 0734-61 29 15 (samma på Signal)

I den här veckans avsnitt ska vi berätta om ett fall som involverar en utpekad dödspatrull från Växjö - och ett mordförsök, som sker bara några meter från en tingsrätt. Senare i avsnittet går vi igenom veckans utveckling i Fallet Molly - den 14-åriga flickan från från Falun som dog förra året efter en festkväll där hon blandat Tramadol och alkohol. Nu har den 18-årige man som tros ha sålt drogerna till henne, flytt utomlands - och rättegången som skulle börjat i onsdags, har ställts in. Reporter: Marcus Ulvsand Tips & kontakt: marcus.ulvsand@aftonbladet.se

Tonåren är viktiga år då hjärnan utvecklas på flera plan och konsekvenstänket kan svikta. Samtidigt är det ofta då som de flesta testar droger för första gången. Hur påverkas den unga hjärnan av detta? Lyssna på alla avsnitt i Sveriges Radio Play. Finns det ett gap mellan vuxenvärldens förmanande hållning till droger och ungdomars lust att prova? - Det finns en fördom om att det bara är folk som mår dåligt som tar droger och att det sker i dåliga sammanhang. Men det kan pågå i roliga sammanhang också. Det är skillnad på att testa och att missbruka, föräldrar är ofta väldigt rädda för droger men borde prata mer avdramatiserat om riskerna. Då skulle man lättare våga säga att man testat, berättar en tjej som går på gymnasiet.- Att hamnar där är verkligen jätteenkelt, det kan hända vem som helst var som helst. Men att sluta kan vara så himla svårt. Det berättar Vilda som hamnade i blandmissbruk i ung ålder.I Danmark har man de senaste åren implementerat en ny metod som kallas MOVE i behandlingen av unga med missbruk. Den går ut på en kombination av bland annat KBT och Motiverande samtal. För att få ungdomarna att ta sig till de viktiga behandlande samtalen får de ett presentkort vid vartannat tillfälle.Medverkande: Hanna Brännlund från Maria ungdom, Joar Gutestam från KI och Sheila Jones, högskolan i Dalarna.Programledare: Ulrika Hjalmarson NeidemanProducent: Clara Lowden

Der er gennem længere tid set en stigende tendens til at unge mennesker er begyndt at bruge Tramadol som 'go-to' præparat, for at opnå en rus. Det er mange gange tabletter der er stammer fra udlandet og dosis pr. tablet der ligger væsentlig højere, end den anbefalede dosis mod smerter som vi har i Danmark. Problemet med Tramadol er at det er yderst vanedannende, og at det ved højere dosis som der indtages af brugere som ønsker at bruge det som rusmiddel er risiko for at brugerne får det man kalder serotonin-syndrom hvor de kan ende med at krampe, og i værste fald får maglin hyperthermi som i den sidste ende kan være fatalt. Hør med her hvor Hjalte forklarer om netop dette. Hjalte er Paramediciner og Instruktør i Akutberedskabet i Region Hovedstaden, og holdte et oplæg om netop dette, på en af vores instruktørsamlinger, for os andre instruktører og vores Ledende overlæge. God fornøjelse! FOAMmedic Podcast · Tramadol og kramper | ep. 85 Abonner eller hent via iTunes for iOS og for android via Podbean. Kan også høre via TUNE IN, STITCHER, Podimo og Soundcloud Referencer: Bivirkningsindberetning Tramadol. Lægemiddelsstyrelsen Undersøgelse af kramper hos 15-30 årige udløst af Tramadol Seretonin Syndrom Øget refleks og clonus ved Seretonin syndrom

🇨🇴 NAIRO QUINTANA renovó con MOVISTAR TEAM una temporada más. ¿Te parece merecida la renovación? Repasamos cómo fue su fichaje por el equipo español tras su positivo por Tramadol y lo que puede dar en 2025. ⚠️ ¿Quieres ayudarnos? Puedes contribuir y convertirte en mecenas de La Bicicleta Podcast en Patreon. Desde 1,50€ al mes puedes ayudar a que sigamos aquí contigo cada día. https://patreon.com/LaBicicletaPodcast?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink 🚀 Únete al canal de Telegram: https://t.me/boost/LaBicicletaPodcast Nos escuchas también en el Podcast Oficial de La Vuelta: https://www.ivoox.com/podcast-vuelta-podcast-oficial_sq_f11080118_1.html

En la última década, los diagnósticos de enfermedad renal crónica (ERC) se multiplicaron por cinco y convirtieron a esta enfermedad en la de más rápido crecimiento del país. El problema es nacional, pero especialmente agudo en la costa sur. Un audioreportaje de No Ficción. Locución: Elsa Amanda Chiquitó. Investigación y texto: Asier Andrés.

Diane Wattrelos, 34 ans, souffre d'une maladie neurologique rare et extrêmement douloureuse, une algie vasculaire de la face, depuis qu'elle a 14 ans. Pour calmer la douleur, les médecins lui prescrivent dès les premières crises du tramadol, un médicament de la famille des opioïdes, qui expose à un risque de dépendance. Au fil des années,aucun de ses médecins ne la prévient du risque d'addiction, et sans s'en rendre compte, Diane Wattrelos devient dépendante de ce médicament qui la soulage. Un jour, elle réalise grâce à un reportage à la télévision qu'elle est devenu addict au tramadol. Elle entame alors un combat pour se sevrer et s'engage pour lever le tabou de l'addiction aux médicaments.Diane Wattrelos a raconté son parcours dans un livre, « Addict sur ordonnance. Ça n'arrive pas qu'aux autres : le cri d'alerte d'une maman sur les opioïdes légaux », sorti en juin 2024 aux éditions Leduc. Elle témoigne dans Code source au micro de Barbara Gouy.Si vous avez besoin d'aide, l'Agence nationale de santé publique a mis en place un numéro d'écoute gratuit et disponible 7j/7 de 8h à 2h du matin : 0 800 23 13 13.Écoutez Code source sur toutes les plates-formes audio : Apple Podcast (iPhone, iPad), Amazon Music, Podcast Addict ou Castbox, Deezer, Spotify.Crédits. Direction de la rédaction : Pierre Chausse - Rédacteur en chef : Jules Lavie - Reporter : Barbara Gouy - Production : Clara Garnier-Amouroux et Clara Grouzis - Réalisation et mixage : Marec Panchot. - Musiques : François Clos, Audio Network. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

In this podcast recorded in early August, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the September issue of DTB. They discuss the editorial (https://dtb.bmj.com/content/62/9/130) that highlights some of the challenges associated with NHS England's national medicines optimisation measures for Integrated Care Boards. They talk about the MHRA's recent safety alert on the risk of an interaction between tramadol and warfarin (https://dtb.bmj.com/content/62/9/131), which was prompted by a coroner's prevention of future deaths report (summarised in a DTB article in March https://dtb.bmj.com/content/62/3/36). The main article reviews the evidence for icosapent ethyl for cardiovascular risk reduction (https://dtb.bmj.com/content/62/9/135).   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email dtb@bmj.com. Thank you for listening.

Michael “Morgs” Morgan is a 30-year veteran of law enforcement who honorably served the citizens of Atlanta, Georgia, and Suffolk County, New York. In this riveting episode Morgs shares some of the heartbreaking trauma he experienced, starting with his first night as a trainee. As a warrior and law enforcement officer he was forced to compartmentalize and press forward, with each incident adding a layer of pain and trauma. The drowning of a 2-year-old child he ‘helped save' caused unbelievable grief. Later in his career he is taken off the streets because of a back injury. He got hooked on the pain reliever Tramadol and ended up in rehab. A couple years ago he saw tier one operators on podcasts sharing their healing journeys with psychedelic assisted therapy and felt the call of the medicine. He sat with Ayahuasca in Florida, and it completely saved and changed his life. He was given a new mission to put the ladder down to help save and change the lives of other first responder heroes and their families. Follow Morg on Instagram team_morgs_inc

Läkaren Johan är på ett apotek. Han ska hämta ut narkotikaklassade läkemedel. Ett recept han har skrivit ut till sig själv. Och det här är långt ifrån första gången han gör det. Lyssna på alla avsnitt i Sveriges Radio Play. Ett recept på det narkotikaklassade läkemedlet Tramadol mot huvudvärk blir början på ett långvarigt missbruk för läkaren Johan. Medicinerna hjälper mot den oro och stress han känner i livet säger han.”Det blir ett verktyg för att orka arbeta mer. Men samtidigt underhåller beroendet ångesten, oron och stressen. Det blir en ond spiral”När missbruket är som värst har Johan under en månads tid hämtat ut nästan 450 narkotikaklassade tabletter på apoteket till sig själv.Bristfälligt kontrollsystemI Sverige har man som läkare rätt att egenförskriva recept. Det innebär att man får skriva ut läkemedel till sig själv. Antalet läkare som blir av med sin legitimation eller får prövotid, alltså att man under en tid är under uppsikt, på grund av missbruk har ökat de senaste åren. I flera fall har läkarna skrivit ut narkotikaklassade läkemedel till sig själva.Och kontrollsystemet som ska fånga upp läkare som överförskriver narkotika har brister. Nu höjs röster för att läkares rätt att skriva ut mediciner för eget bruk behöver regleras. Vårdpersonalen och missbruket är en serie av Magdalena Brander från 2024. Johan heter egentligen någonting annat. Producent: Anna FreySlutmix: Staffan Schöier

In 2023, the opioid crisis claimed over 81,000 lives -- a staggering number, yet many of these deaths could have been prevented. While prescription opioids can be essential for managing pain, they come with significant risks that are often overlooked. In this episode, we dive deep into the hidden dangers of opioid prescriptions and explore the crucial questions you should ask before accepting these medications. Ellen Eaton, MD, a leading expert in opioid treatment from the University of Alabama Birmingham, joins us to discuss the real risks of misuse, the warning signs to watch for, and the steps you can take to protect yourself and your loved ones. From understanding the potential side effects, to navigating the road to recovery, this conversation sheds light on the opioid epidemic and the urgent need for prevention and education. UAB Medicine Addiction Recovery Services Transcript Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered Podcast. I'm Dr Neha Pathak, WebMD's, Chief Physician Editor for Health and Lifestyle Medicine. Many of us have talked to our children and loved ones about how to respond if they're offered an opioid or some other unknown substance, even if it's candy at a party, fearing the dangers of opioids and overdose. But how many of us think about the risks in these situations? Our child is injured playing sports and we're given a 14-day prescription for an opioid containing medication. We're at the dentist's office and we're given a prescription for an opioid for a short course after a procedure. New data shows that there were over 81,000 opioid deaths in 2023. So, what can we do to keep our loved ones safe? Today we'll talk about the best strategies to prevent opioid misuse and abuse in the first place. Even if it starts with a prescription from our doctor's office. The journey to addiction and to recovery and what we need to know about preventing opioid deaths.   But first, let me introduce my guest, Dr Ellen Eaton. Dr Eaton is an associate professor at the Department of Medicine at the University of Alabama at Birmingham. She's the director of the office based opioid treatment clinic at the UAB 1917 clinic, and a member of the leadership team of the UAB Center for Addiction and Pain Prevention and Intervention. Welcome to the WebMD Health Discovered podcast, Dr Eaton. Ellen Eaton, MD: Thank you so much for having me. Pathak: I'd love to just start by asking you about your own personal health discovery. So, what was your aha moment that led you to the work that you're doing with opioid treatment, management, and addiction and pain prevention interventions? Eaton: Yeah, I have an interesting story as an infectious diseases physician who is primarily working on substance use treatment and prevention. I had the honor of being a fellow with the National Academy of Medicine, really a health policy fellowship. And as an infectious disease physician, I was invited to a working group around infectious consequences of the opioid epidemic. And that was in 2017. It was a tremendous opportunity to go to D.C. and work with thought leaders in the field, other physician scientists, infectious diseases doctors, and those experiences and treatment models that I was hearing about in D.C. were not happening in my home institution at UAB. There were addiction medicine physicians, but we hadn't integrated care. We were not doing syndemic care where you're treating the infection, preventing Hep C, and you're treating their substance use disorder. So that opportunity in 2017 inspired me to come home to UAB, create a clinic here that is for our patients living with HIV who have opioid use disorder, and from there, we've really expanded services broadly for substance use and infectious diseases. So really grateful for the National Academy and that opportunity. That really was a launch pad for my career. Pathak: I would love to talk about what you've seen as the entry point for a lot of people when it comes to opioids and that progression to addiction, potentially overdose. What does that look like for many of the people that you see? Eaton: Because of the care I provide, I am seeing patients who are living with substance use disorder, but I always start when I meet them with really open-ended questions like tell me about your first exposure to opioids. Tell me when you began using them for medical reasons or recreationally. And what I hear over and over again is that many of our patients are starting to experiment or use from a prescriber for a medical condition in their teens or early twenties. And that is often a trusted medical provider. It may be an urgent care physician for a musculoskeletal injury, for a teenager on the athletic field who was injured. It may be a woman who just delivered a baby, a very healthy, common touch point, where there may have been a tear or maybe some residual pain.   Another common touch point is a dentist treating you for a dental infection. And so, I hear these types of anecdotes over and over from my patients, and often it is a trusted physician, so they don't feel like this is a scary medication. They may be given a 14-day supply of opioids, not realizing that can lead to physical dependency and opioid misuse in the future. And often don't ask questions about what to look for, warning signs, and certainly as young people, I haven't ever heard that their caregiver expressed concerns. I think more often the patient has a prolonged course seeking opioids for various conditions, becomes dependent, is seeking them more and more, and often caregivers or family members don't get involved until they are pretty far down the continuum of opioid use disorder. So, those are the stories I hear when I meet patients and ask about their journey. Pathak: What are some of the questions we should ask before we even accept that prescription? Eaton: This is a really important question at that prevention touch point, that we often miss. I think asking your provider do you really need oxycodone. Could you start with something like an NSAID or a Tylenol. Asking your provider to be very explicit. When my pain hits a seven out of 10, when my pain hits an eight or nine out of 10, when do I need to take this opioid as opposed to some other opioids sparing pain modulators? And then number of days. So not just at what point today, but also tomorrow, the next day, what pain should I expect, and I think setting the expectation you will have some pain. This is a challenge that many of us that see patients in a primary care setting have to remind patients, you will have some pain. That is normal. That is healthy. That means your nerves are telling you they're giving you feedback on what's going on after your leg fracture. And I think unfortunately opioids have been normalized as safe, in many cases they can be, but in many cases they are not.   I also see amongst families where an individual will tell me, “Oh, well, I got a Tramadol from grandma, or I had some opioids leftover from that time that I had a surgery and so I took that for some other condition,” comparing them to medications like chemotherapy, which also have risks. You would never hear a patient self-medicating, sharing with friends and loved ones. But I think because opioids became so ubiquitous, in past decades, entire families, kind of normalize them. They feel comfortable sharing them, taking others. And that type of culture leads to a culture where young people feel comfortable experimenting. They take pills at parties, they take pills from friends and, they purchase them off social media, like TikTok for example, because they do not appreciate the adverse outcomes that can be associated with these types of medications. Pathak: So, tell us about this slippery slope. What is it that happens to us when we take these medications unnecessarily? Eaton: Often one of the biggest teaching points that I make with trainees in my clinic, when is someone experimenting and when does it become a use disorder? And in my clinic, it's usually pretty clear and that includes negative consequences. So, taking opioids and falling asleep, nodding out, overdosing, right? Those patients have gone from opioid misuse to use disorder. So having negative consequences, becoming physically dependent. We do see that needing to take more and more to prevent withdrawals, which with opioids, unlike some other substances, you can pretty quickly become physically dependent. And then you need to continue to opioids just to not feel sick, to not have the flu-like symptoms. So, becoming physically dependent, having to take more and more, increasing your dose to get the same desired effect. Those are the things that I see most commonly in clinic. With opioids and certainly the very potent non-medical opioids we're seeing now, heroin, fentanyl, we don't see people who just dabble here and there at a party, at a wedding.   Now the other substances that I see pretty routinely used in my clinic with or without opioid use disorder, stimulant use disorder, marijuana use disorder. Alcohol use. I do have to ask more questions and certainly there are validated screening tools out there that physicians and clinicians can use to determine very objectively. Did they just drink too much at that wedding two months ago and it was a problem because they got in a fight or had a DUI? Or is this a pattern of use that meets criteria for alcohol use disorder?   So, it is important to ask those questions and know, but I would say really the negative consequences, the physical dependency, escalating use, those are things to look for in your patients. As a caregiver or a parent, those are things to look for as well because we are really in a position to identify these before our loved ones have escalated their use. Pathak: And then what do you do? So, you notice some of these types of red flags. What is the intervention that you should make as a parent or a loved one or a caregiver? Eaton: I think starting with a primary care provider is always the best step. And most of us do use these objective screening tools. There are several you can find. My clinic uses an assist. These are validated tools that have been tested on many patients, not physicians, not PhD scientists, that have been tested on patients to make sure that they are asking the right questions to get to the true use behaviors and patterns. And I would go from there with your primary care provider.   I think if you as a parent or loved one are even asking yourself, is it time to go? It's time to go. I think too many of us wait until there are very obvious motor vehicle accidents, overdoses. And I think most parents that I encounter in a clinical setting knew there were issues much longer before they sought help.   And this gets to your question around stigma, shame that a lot of families do not want associated with their loved one or their family. And so, they wait until there are really negative consequences. Ideally, we'd be intervening much sooner. Pathak: I'd love to talk a little bit and dig into what you just said about stigma and shame and some of the words we use when we talk about having a problem, quote unquote, with opioids, or becoming addicted or physically dependent. In that recovery phase, oftentimes we'll talk about someone becoming sober or sobriety from some of these medications. Can you talk a little bit about the terms that you use and what best helps uplift your patients? Eaton: This is a really nuanced area, and it does take some retraining of us as clinicians who have been in practice for a while. When I went through medical school, you were either 100 percent abstinent or not. We weren't taught that there was this whole middle ground of harm reduction, and I think as physicians, once we get some additional education on this, we realize that our words really matter. We can be much more supportive of our patients because this is a journey and much like diabetes or hypertension, your patient may have chapters where they aren't in care. Their chronic disease, substance use to chronic disease, is unmanaged.   But unlike diabetes or hypertension, where we just counsel them and support them and bring them in maybe more frequently to check in, have them bring their spouse to help with the pill bottles and set their phone alarms so they don't forget. Unlike those medical conditions, this chronic brain disease of substance use, we treat patients unintentionally as if they have failed. They have failed our clinics. They have failed the treatment. We treat them with judgment and shame. And there are a lot of complex routes for that that I am not an expert in. But what I tell my colleagues and my trainees is that we need to know and our patients need to know that they have not failed us. They are not a failure. They are living with a chronic disease, just like diabetes or hypertension. And just like diabetes or hypertension, if they fall out of care, if they stop taking their medications, we allow them to come back when they're ready to reengage. Just like my patients with HIV, right? So, using words are often the first interaction that we have with our patients. I even say when I get to meet them, “tell me about your journey. Have you ever been in recovery before?” rather than tell me about your addiction. “Have you ever been abstinent?” Have you ever been sober? Did you fall off the wagon? These are all terms that have very negative connotations and really reinforce a lot of the stigma that our patients already feel. My patients come with a lot of stigma to clinic. I have to remind them not to use stigmatizing words to describe themselves. They'll say things like, “I've really been an addict for 20 years.” And I have to say, “you've been a survivor for 20 years. You've been a survivor.” Or, you know, I'm the black sheep of my family. And I remind them. Actually, you have a chronic disease, and didn't you tell me your uncle has the same brain disease it runs in your family? Just reminding them much like the diabetes example again, this is a chronic disease. Those are some of the strategies I use to be really person centered and inclusive. And I do use the survivor language a lot. If they're using opioids in 2024, they are a survivor because we know the substance is out there. I do try to use a lot of empowering language as well. Pathak: I come at a lot of this from the primary care lens. I'm a primary care physician and prevention is the key for what we're always trying to do before we get to treatment and management. If we're talking about red flags or the types of questions we should be asking before we even prescribe these the first time, is it asking about family history? Should our patients be thinking about that? Like, oh, you know, Uncle Jim has had a problem with opioids in the past. That's probably not a medication we want to start in our child. What are some of the other types of questions we can be asking before we even think about that very first prescription or letting your child know that this is something that you need to be thinking about if you're at a party and someone offers you something because this is our family history. What are some of the other things you ask about?   Eaton: Family history is really important. Past experience with opioids. And if you have a patient who is in recovery, many of them will say, I know I have to have my hip replaced. Please do everything you can. Give me blocks. They want to avoid opioids. So, asking about any experience with opioids, how that went.   I would also ask about social support. You know, remind me where you're living these days. Oh, you're in an apartment with your niece. Do you have a safe place to store your medications? Tell me about that. Where do you store your medications? This comes up a lot with our unhoused population, that they are frequently having to move. Their medications are often stolen. That doesn't mean that they don't meet criteria for opioids. It may just mean you need to be more thoughtful. Do you need to go to a boarding care or shelter while we get through this period where you're recovering from your injury and you need opioids to be kept in a locked box? I think those are most of them. And then just appreciating that things like a history of trauma and social determinants of health are really going to put our patients at risk. And a lot of the young people that I see are 30 and 40 year olds who started experimenting with substances in their teens and 20s were in these multi-generational households where mom had substance use. Grandma had substance use. There were always pills around.   So, if you are seeing a patient who has a lack of social structure, living with other people with substance use, without a lot of accountability boundaries, without close follow up with a physician, that may be someone you want to consider alternatives or, you know, give them a three-day supply post op and bring them back. Right? Clinics are so full. We may not have that structure or care model in place, but that's ideal. Giving a short course. Reassess. Maybe it's time to transition something else.   Pathak: Great. Can you help us understand what exactly an overdose is? What does it look like? And what are some of the strategies like naloxone that we should be aware of? Eaton: Yeah. So right now, we're seeing the vast majority of overdoses have opioids as a contributing substance. So many of our decedents who pass away and have toxicology results have multiple substances, including stimulants. But currently, fentanyl is contaminating so many types of street drugs, whether they're a counterfeit, benzodiazepine, or a counterfeit Vicodin, or cocaine.   So, the vast majority of overdoses we're seeing right now, are opioid related, and that usually involves people looking sedated, stuporous, failure to respond to verbal stimuli, tactile stimuli. And in the current setting where we're seeing so many overdoses, I think you should always think opioids first when you're seeing someone like that. It is important to approach them, call their name, shake them if they don't respond. That's when you're going to call 9-1-1 and be looking for naloxone.   I have some in my backpack. I travel on airplanes with naloxone. And my kids who are elementary age know about naloxone. I haven't gotten to the point of educating them. But because these events are more common than cardiac arrest in many, many communities, we're training our Boy Scouts how to do CPR, but we're not necessarily training our Boy Scouts how to do naloxone for overdose reversal. But we should.   These are happening in schools. If you have a young person in your home, if you have a teenager in your home, you should have naloxone, and your teenager should as well and be trained to use. It doesn't mean your teenager is using or experimenting. It just means the people in places that young person is around have a higher likelihood of overdose than a cardiac arrest in many settings. Right? I know a lot of schools. My community schools are getting naloxone because they do appreciate that children are experiencing at school. They've had some adverse outcomes in my state on school property.   I would encourage anyone who is living with young people or older people who have access to opioids, even prescription opioids, to have naloxone. And then obviously if you know your loved one has opioid use disorder, you and they and anyone who is a caregiver for them should have naloxone on their person. Truly. So that's pretty much all of us, right? And whenever I talk to the rotary, I've talked to schools, I talked to clinicians. There are very few people who don't need to know about naloxone in the current day and age. And think of compared to something like an AED or CPR. You know, we're really good about these less stigmatized acute medical events, right?   We feel very comfortable training our Boy Scouts on how to do this, and we feel very comfortable putting an AED on our walking trails and at our gyms. Because of the stigma around substance use, we do not have naloxone in many of those community spaces, and we have not trained our community to respond to overdose in the same way we have cardiac events. Pathak: What would be part of your counseling in a Boy Scout troop or Girl Scout troop or at school to share that part of the information? How do you use something like a naloxone? What are the signs that you're looking for?   Eaton: I think this is a great topic for Boy Scout and Girl Scout troops and for health education courses for middle school. By talking about it, we're normalizing it. And based on the prevalence of substance use, we should all be aware of the signs or symptoms. So that is very appropriate. There are developmentally appropriate ways to talk about this, even to elementary students. I think sharing the statistics on youth who start experimenting, the average age, the prevalence in communities, the types of places where they may be exposed to opioids that are non-medical, the signs or symptoms of overdose, which we discussed, and the fact that there is a safe, over-the-counter reversal. Naloxone that they can and should carry as a good community citizen and community helper.   I know this will be stigmatized in some areas, and some parents will not feel comfortable with that. But I think the more that we have partnerships between pediatricians, public health officers, and schools and coaches, these types of individuals should really feel comfortable talking about this. It is nothing to stigmatize or shame or your kids aren't going to come to you.   What we want is we want these kids looking out for their friends and their parents. We want this to be something we talk about, and we go to a trusted adult when we have concerns. And that's what it will take as we're speaking to prevention. It will take a village of informed adults, trusted individuals. Who our youth can go to early when someone is just starting to experiment. When your friend just brought pills to a party for the first time. Early intervention, right? So, I think the Boy Scout example is a perfect one, but thinking all the touch points for our young people, churches, the faith-based community. And we recently did a pop up with an AME church here in the deep South. Who wanted to have a pop up. It was myself and a community agency that I work with called the Addiction Prevention Coalition. They do great work. I'm delighted that they've included me, and we passed out naloxone and we talked to these church members, many of whom were elderly. They were grandparents. They're worried about their grandkids. They're worried about what they're seeing in the news. They're worried that these kids are going out partying and they know that there are substances involved. So, another great touch point, just thinking across the age continuum, all the people who are part of communities who can be on the prevention arm of substance use. Pathak: That's really helpful and really interesting. So, we've talked a little bit about prevention, overdose prevention. We've talked about substance misuse and what that can look like. What does the process of achieving and maintaining recovery look like? When someone comes to your clinic, because that's really the goal of their treatment, how do you get started? Eaton: So just thinking about the term recovery, we use to describe someone who has reached a point where they're not using any non-medical substances, but it's important that we have each patient define that for themselves. I have many patients who are in recovery from alcohol and opioids. They cannot give up cigarettes and they're not ready to, right? I would never tell them you're not there yet. But I congratulate them on every step, and I remind them you've been in recovery from opioid use for 10 years. You've been in recovery from alcohol use for five years. You don't want to talk about tobacco today. That's fine. Look how far you've come.   And that is part of just supporting them in their journey and encouraging them. There are some people who are going to return to use. I never say fall off the wagon. I never say, you know, other stigmatizing terms. Return to use. There are some of my patients, specifically with opioid use disorder, common triggers, a breakup, a job loss, housing loss, death in the family. I do see patients return to use.   It's less common when they have been on a stable medication for opioid use disorder like buprenorphine and they are engaged in medical care. They have some counseling or group that they can go to for support and accountability, but it still happens. And then once we get them back into our clinic and we initiate the treatment again, and we follow them very, very closely in that very fragile time, you're back in care. Let's start you back on buprenorphine, for example. Let's check in with you in a week. And I have a peer counselor in my clinic who has lived experience with substance use. She's the perfect person. She's been there. She sees them very frequently over that period until we can get them back into recovery. For opioid use disorder, it is pretty clear from their behaviors. It is so physically addictive. It is so disruptive to relationships that I have very few people who can dabble with opioids. Because usually once they return, they are back in active use, is the term we use.   Pathak: And as we close out our episode, I'd love to invite you to share some bite sized action items to help create change in our lives if we are caring for a loved one, a child who may be experiencing some of the symptoms that you described.   Eaton: Absolutely. I think thinking about their survival analogy can be very encouraging and not overwhelming. Just do the next step. I think many of us want to fix our loved one. We may want to fix our child, but what is the next step? The next step may just be getting your loved one to a doctor's appointment, and that's a win. They showed up, right? Then the next step may be getting them to commit to like goals. It's not accomplishing the goals. It's just having them identify what matters to them. You know, so do these baby steps make recovery seem much less overwhelming if recovery is the goal? But I think just viewing caregiving and living with substance use as survival. And being kind to yourself, being kind to your loved ones who's living with this chronic medical condition and taking things one step at a time. Pathak: Thank you so much for being with us today. Eaton: My pleasure. Thanks for having me. Pathak: We've talked with Dr Ellen Eaton today about prevention. How do you even prevent that first use of opioid if it's not necessary? And we've talked about the journey of addiction to recovery. To find out more information about Dr Eaton, we'll have information about her and her clinic in our show notes. But you can check out the Center for Addiction and Pain Prevention page. And again, we'll have that link in our show notes. Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at webmdpodcast@webmd.net.   This is Dr Neha Pathak for the WebMD Health Discovered podcast. 

Bir hap düşünün ki insanın acılarını dindirsin, ulaşımı kolay olsun, hem de ucuz olsun. Afrika halkının ve hatta teröristlerin kullandığı Tramadol adeta bir kabus gibi kıtanın üzerine çökmüş durumda. Gelin bu kaçık hikayeye hep beraber dalalım! Support the Show.Bize ulaşmak için: Twitter @hkbu_podcast İnstagram @hkbu.podcast Facebook hkbupodcast.com hkbu.podcast@gmail.com Bizimle yolculuğa devam ettiğin için teşekkürler!

Längst fram i kapellet står en ljus kista fullklottrad med personliga meddelanden. I kistan, klädd i sin bästa klänning, ligger 17-åriga Emilia, död i en överdos. Lyssna på alla avsnitt i Sveriges Radio Play. När Emilia hittas livlös i en soffa är hon den andra tonårsflickan i Göteborg på bara några dagar som dör i en överdos. Emilia har vid det laget kämpat mot missbruket sedan 12-årsåldern.– Jag visste det här, jag visste att det skulle bli dödlig utgång, säger hennes mamma Linda.Precis som för många andra unga tjejer började Emilias missbruk med drogen Tramadol, en smärtstillande men också prestationshöjande opioid som kan jämföras med heroin.– Jag förstår tjusningen med att testa Tramadol: ”Jag fick ju bättre betyg här, jag klarade av skolan mycket bättre. Men vänta nu, mina pengar räcker inte, jag kan inte gå och lägga mig utan tabletter”. Börjar du med Tramadol medicinerar du dig själv till döden, säger poliskommissarie Mika Jörnelius.Användandet av Tramadol bland unga ökar. Undersökningar visar att den som tar Tramadol är mer benägen att testa andra tyngre droger. För Emilia var det till slut en överdos rökheroin som tog hennes liv.– Hon tackade mig för att jag alltid har stått vid hennes sida. Jag säger inte att hon gjorde det medvetet, att hon tog sitt liv. Men hon hade en längtan att gå vidare, för att hon inte orkade längre.Reporter: Ulrika NandraProducenter: Martin Jönsson och Sofia KottorpSlutmix: Elvira BjörnfotFrån 2020

In this episode I answer 3 questions from the hospice nurse support group on facebook.  The first question has to do with giving liquid morphine every 6 hours scheduled and PRN morphine every 3 hours PRN.The second question involves using Tramadol for pain management.The third question has to do with elevated vital signs for actively dying patients.==============================As always, don't forget to call, text or email to leave feedback! I would love to hear from you!816-834-9191James@confessionsofahospicenurse.net==============================Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

När 13-åriga Vilda ska köpa cannabis i Nordstan blir hon erbjuden en gratiskarta Tramadol. Sedan går allt fort utför mot ett svårt blandmissbruk som hon nu kämpar mot varje dag. Lyssna på alla avsnitt i Sveriges Radio Play. Cannabis var den först drogen Vilda började med. Då var hon 11 år. När hon sedan som 13-åring blev erbjuden en gratiskarta Tramadol gick det fort.– Det är som världens kortaste centimeter. Jag trodde aldrig att jag skulle bli beroende av droger, säger Vilda.När Vilda berättar om vilka droger hon tagit blir listan lång: cannabis, tramadol, ecstasy, tjack, kokain, LSD, lyrica, ”blå”, antipsykotiska läkemedel, någon annans ADHD-medicin. Ibland köper hon droger för sina fickpengar, ibland handlar hon på ”krita,” men hon blir också erbjuden droger. Ibland med sex som motkrav.När Vilda berättar om sin kamp mot drogerna är det en mörk bild där den rätta hjälpen från myndigheterna som socialtjänst och BUP tar lång tid med utredningar och handläggningstider, besök som Vilda inte tycker ger något.Mini-Maria är en ungdomsmottagning för unga med drogproblem och finns i Göteborg, Malmö och Stockholm. Alexander Holmstedt, psykaitrisköterska vid Mini-Maria i Malmö delar bilden Vilda ger.– Vi har tydligt sett att när unga väl går över gränsen från cannabis till Tramadol blir det en väldigt mycket större risk för att snabbt hamna i ett blandmissbruk. Det vi också har sett är att tidigare arbetssätt är otillräckliga och det krävs helt andra arbetsmetoder för den här gruppen som tar Tramadol och blandar drogerna.Tramadol, det smärstillande opiodläkemedlet har ökat explosionsartat de senaste tio åren. Under 2019 beslagtogs nära en miljon tabletter. För många unga är Tramadol vägen in i ett djupt blandmissbruk och till och med död. Under 2019 dog 126 unga mellan 15-29 år av överdoser.– Gör vi ingenting nu kommer vi har en större grupp opioid- och benso (bensodipiaziner) missbrukare än vad vi har sett tidigare, säger Alexander Holmstedt som initierade Tramadolprojektet, en kartläggning och forskningsstudie över Tramadol bland unga i Sverige.Reporter: Ulrika NandraProducenter: Sofia Kottorp och Martin Jönsson Slutmix: Elvira BjörnfotProgrammet är gjort 2020

In this week's episode, we dive deep into a groundbreaking study that shows how chiropractic care can significantly reduce tramadol prescriptions in adults with radicular low back pain. We explored how tramadol, an atypical synthetic opioid, is often prescribed and the implications of that, contrasting it with the benefits and effectiveness of chiropractic spinal manipulation. This research highlights the dire need for guideline-concordant care pathways and how chiropractors play a crucial role in providing safer, more effective alternatives to opioids.Episode Notes: Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back painThe Best Objective Assessment of the Cervical Spine- Provide reliable assessments and exercises for Neuromuscular Control, Proprioception, Range of Motion, and Sensorimotor-Integration. Learn more at NeckCare.comInterested in ShockWave technology? I built a practice using StemWave and can't recommend it enough. Learn more at- https://gostemwave.com/theevidencebasedchiropractor Patient Pilot by The Smart Chiropractor is the fastest, easiest to generate weekly patient reactivations on autopilot…without spending any money on advertising. Click here to schedule a call with our team.Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

Dive into the realm of advanced pain management with Dr. Mark Epstein, as he unveils the latest on Tramadol, Gabapentinoids, and more in our dedicated pain management series. Quick Summary: This episode, part of a five-episode series from a comprehensive workshop held in late 2023, focuses on Tramadol, Gabapentinoids, and their roles in veterinary pain management. Dr. Mark Epstein, a renowned expert, discusses the effectiveness, applications, and considerations of these medications in dogs and cats, offering practitioners insights to enhance patient care. Speaker: Dr. Mark Epstein, DVM, DABVP, CVPP, a leading authority in veterinary pain management, shares his expertise. Dr. Epstein is the medical director at Total Bond Veterinary Hospitals, North Carolina, and a celebrated figure in the field, having led significant pain management guideline programs. Main Talking Points: Tramadol's Efficacy: Exploration of Tramadol's varying effectiveness in dogs versus cats, highlighting its limitations and potential uses. Gabapentinoids: Discussion on Gabapentin and Pregabalin's roles in treating neuropathic pain, with specific dosing insights for both species. Emerging Therapies: Introduction to promising medications like Amantadine and Acetaminophen, outlining their contributions to multi-modal pain management strategies. Interesting Quotes: "The conversations about Tramadol... pretty much settled by now that the oral form of it in dogs is simply no strong evidence that it's effective." - Dr. Epstein "When it comes to dogs... we need more evidence to show it. So this is like going to be a therapeutic in progress of its study." - Dr. Epstein on Tapentadol "We can say with some confidence that [Gabapentinoids] can have a benefit when there's a neuropathic component to pain." - Dr. Epstein Timestamps: 0:00 - Introduction  2:05 - Tramadol's efficacy and limitations 5:40 - Gabapentinoids in pain management 10:25 - Insights into Amantadine and Acetaminophen 11:00 - Final thoughts   Visit IVDI.org to learn more about the Veterinary Dental Practitioner Program. Tune in next week for more insights into veterinary dentistry and pain management.   This episode provides a deep dive into the complexities of using Tramadol and Gabapentinoids for managing pain in veterinary patients, guided by Dr. Mark Epstein's rich experience and research. By dissecting the latest findings and practical considerations, veterinarians and technicians can glean valuable strategies for optimizing pain management in their practice. Affiliate & Sponsor Links: This series is brought to you by the International Veterinary Dentistry Institute (IVDI.org), offering comprehensive training to elevate your veterinary dentistry skills.

The best stories I read in February of 2024. Sorry it is not over an hour, I did not create as much content this month as you already know! We got air duster stories and even Tramadol this month!

Bobbi rants about the "other" pain medications. Host: Dr. Bobbi Conner Producer: Topher Conlan

Addiction treatment centres across India are observing an uptick in patients grappling with abuse of opium-derived painkillers like Tramadol, specialists say.

Brian fights through the pain to give you the quality content you've come to expect from this podcast! For our Stories of the week, we talk about a Florida woman scorned and a woman who may have killed people with some bad mushrooms. Senator Bob Menendez is facing corruption charges (again), the Senate dress code is relaxed, and we discuss the prisoner exchange with Iran. NFTs are worthless, the Oakland A's gave Miguel Cabrera a bad gift, and we give you our NFL Locks of the Week! We also have two of our most beloved segments: But The Drag Queens Are The Problem and What Are We Watching!

Delving into the controversy surrounding Nairo Quintana's positive tests for tramadol during the 2022 Tour de France. We discuss the complex considerations surrounding the substance's classification, its potential impact on performance, and recent developments that have prompted new discussions.Plus, 750D? Another new wheel size has been revealed, this time for gravel bikes, more controversy, team finances, and the social media rounds.Watch this on Youtube: https://youtu.be/pjvUKLWDWeYWADA Twitter post: https://twitter.com/wada_ama/status/1574912951995322369Tramadol study on Outside Online: https://www.outsideonline.com/health/training-performance/New Gravel Bike Wheel Size on Instagram: https://www.instagram.com/p/CwQZImfh4Tg/?hl=enLotto-Dstny terminates Allan Davis' employment: https://www.cyclingnews.com/news/lotto-dstny-terminates-allan-davis-employment-following-inappropriate-social-media-messages/Article on swapping Giro and Vuelta dates: https://www.cyclist.co.uk/in-depth/giro-vuelta-weather-swapGroupama-FDJ finances: https://inrng.com/2023/08/groupama-fdj-finances-2021/Greg Van Avermaet Instagram post: https://www.instagram.com/p/Cvw7m9XMJCx/Sam Gaze MTB Rider Instagram post: https://www.instagram.com/p/CwSvfgKr-4F/Robert Gesink Instagram post: https://www.instagram.com/p/CwS30aGt-VT/?img_index=6

Episode Summary Margaret and Agatha talk about mutual aid in Ukraine and Agatha's experience trying to go there to fight in an anti-authoritarian platoon, but ending up doing a bunch of mutual aid supply distribution work instead. They talk about he intricacies of relief work and some of the special circumstances in Ukraine. Heavy content warning on this episode. Towards the end of the episode around 46:00, Agatha starts to tell a really intense story about being in a war zone. Around 56:00 is when it begins to get graphic. Guest Info Agatha (they/them) can be found on IG @jalutkewicz You can donate to their mutual aid work on venmo @agathawilliams or on Paypal @jalutkewicz@gmail.com Host Info Margaret can be found on twitter @magpiekilljoy or instagram at @margaretkilljoy. Publisher Info This show is published by Strangers in A Tangled Wilderness. We can be found at www.tangledwilderness.org, or on Twitter @TangledWild and Instagram @Tangled_Wilderness. You can support the show on Patreon at www.patreon.com/strangersinatangledwilderness. Transcript Agatha on Ukrainian Mutual Aid Margaret 00:14 Hello and welcome to Live Like the World is Dying, your podcast for it feels like the end times. I'm your host, Margaret Killjoy. And I'm really excited about this week's interview, I am going to be talking to an old friend of mine from quite a while back who haven't talked to in a while about what's involved in anarchists mutual aid in war zones, and specifically, Ukraine, and in the things that are going on there. Yeah, I'm really excited for you all to hear this conversation. But first, I'm excited for you all to hear that we're a proud member of the Channel Zero Network of anarchists podcasts. And here's a jingle from another show on the network. Margaret 01:13 This is Margaret, from the future, coming back to say that this episode deserves a content warning near the end of the episode and there'll be some heads up. We will be talking about, "Hey, so I hear you were attacked." That part contains graphic descriptions of war and violence. And so listener discretion is advised. Margaret 02:05 Okay, we're back. So, if you could introduce yourself with your name, your pronouns, and then kind of a brief description of why you are in a good place to talk about anarchists mutual aid in places of active conflict. Agatha 02:20 So my name is Agatha. My pronouns are they/them. Yeah, I went over to Ukraine last year about this time to do mutual aid support with anti authoritarian units and anarchists units. Things got fucked up on my way over there. So, that wasn't a possibility any longer. So, I just started doing aid runs with a convoy of other solo operators who went over there to try and do something to help alleviate the suffering of folks. Yeah, I'm here to talk about that. Margaret 02:57 So one of my questions about that, is, what do these aid runs look like? I'm under the impression there are different organizations working to try to get new vehicles and armor and all of these things that, you know, to frontline units, to anti authoritarian units. And these are like, organizations from outside Ukraine that are like sending people and supplies to then deliver the supplies? Like what does this look like? Agatha 03:25 Yeah, so me and a few other folks went over there with a group of cash all of our own, you know, what I mean, and we use that for operational costs, which was, you know, feeding ourselves buying diesel in Poland. And then we worked with some more wealthy sympathizers to the cause, who, one person we worked with owns a distribution company, and they have a giant fucking warehouse in Warsaw, Poland. And, you know, they would make sure items that needed to get to folks close to the frontline, where bigger NGOs wouldn't go, could get things that they needed that were not getting there, i.e. like medicine, sanitary products, food, you know, and then later on body armor and diesel. So, this person would basically...they have a bigger organization that looks a lot friendlier on their website, and you can go and donate money and it has pictures of like Ukrainian kids smiling. So, the run would start like this, we'd get a text from this wealthy patron and they'd be like, "Alright, I've organized another run," you know, "Meet me at my warehouse Saturday at four in the morning and bring four vans," you know, "and eight drivers." And like, we wouldn't know where we're going. We wouldn't know what we're doing. And then we'd get there at four in the morning and then there'd be all these like, gnarly angry Polish dudes just like moving boxes around and making piles. And then the, you know, the person who lead everything and orchestrated everything, she's just a very strong, amazing woman. And she would come out and just start barking orders and be like, "You, you're driving this van, and you're putting all this in your van, but like, I have some other shit to hide at the bottom of the pile. So don't load it yet," you know, "load this van." And then she'd like really quickly, have one of her cronies, bring out a pallet full of body armor inserts that were like, made at a metal shop out of like, AR500 steel that can withstand 556 and 762 rounds. Margaret 05:31 Yeah, gun Twitter will be very upset about this. Agatha 05:35 What's that? Margaret 05:36 I said gun Twitter will be very upset that they're using steel. Agatha 05:40 I know. But if you're out there fucking around, you want something more than nothing, and it's not gonna spatter, AR500 is at least not going to spatter on you, you know what I mean? Yeah, it's not going to create any spalding. But, that regardless, you know, she did her own research on what steels are like the most bulletproof and then she fucking contacted a metal shop with a brake press that could you know, bend quarter inch thick steel that was hardened. And then she had them plasma cut out the designs that fit into vests that she had manufactured from different tailors around Poland, you know, it was just like, it was 100%, DIY, you know, ballistic vests. And it was just amazing. And she'd be like, "Alright, you're delivering all this, like toilet paper, and ibuprofen, and like, you know, baby food to this one location, then you're going to meet with my people at this location, and you're gonna give them these 10 boxes," you know, and those had whatever in them. I never asked, you know, but and then she'd be like, "Give them these 50 vests," you know, "they have like a poorly equipped unit that needs them. They have a mortar unit that's taken a lot of casualties because they're so ill equipped," like, blah, blah, blah. And then she'd be like, "Also, the next van, we're gonna fill it with all toilet paper. But, at the bottom of the toilet paper pile, we're gonna hide 300 gallons of diesel, you know, in these little containers." Margaret 07:02 Why are you hiding it? Agatha 07:05 Because there's like tariffs involved with transporting body armor and transporting fuel across conflict zone lines, apparently. I don't know very much about it. I just know that like, there was like, a big to do. And you had to file a lot more fucking paperwork that took weeks and weeks, if not months to get like 50 fucking vests across the border, and then to the east of Ukraine. Whereas she was just like," I don't give a fuck, you're going there anyways." I mean, she was crazy. She was like, linked up, she'd be like, "Alright, these are your things you need when you get to the border. If you get there early, wait till 5:30 shift, change or whatever. And wait till this one dude is working. Show him this paperwork, and he's gonna let you through without giving you hassle or looking in your van. If you go at other times, I can't guarantee you're gonna get through without a hassle." So, she had stuff going on, that I didn't know about. And I didn't care to ask about. I was just into helping and I was good enough just bringing food and medicine. You know. When I found out we were bringing other shit and like hiding it. I was like, "Oh, that's cool." I was like, "I'm into it. Like, I'm sketchy. Like, I'm down." you know? And so we just like, we would wait, we'd pack up all the vans at four in the morning when we met her there. And then there was a few Polish dudes who would run the convoy once we were on the road. And we all had radios. So, it's like, you know, head convoy dudes like, "You guys got to pick it up, we need to make better time." or people in the back would be like, "Hey, head of convoy slow down, we're losing ya." Yeah, because all our shit was painted drab green and had the organization we were working for plastered all over the side of it. So, we wanted to look like a convoy while we were in Poland and the West of the country, and stick together. And then once we'd get across the border, and hit Lviv, you know, then it scattered and we would take magnets off, and we didn't want to look like a convoy, because convoys get targeted and like, all this other junk. So we had basically leave Warsaw at like five or six in the morning, we'd drive for fucking ever, we'd get to the border, we'd sit there forever, you know, we'd give our slips to the guy we were supposed to give them to, they would just wave us through, they wouldn't search our shit. And then we drive fucking forever to Lviv. And then at Lviv, we'd unload like 80% of the stuff, you know, four out of six in the convoy would go back to Warsaw. And then you know, I was generally one of the ones who would go further east. So, I'd stick around, we'd get coordinates to a new warehouse that we didn't know about, and then we would go refill our vans and Lviv with other shit going further east. And then from there, we'd hit Kyiv. We'd drop a bunch of shit of in Kyiv. If we were transporting vehicles, we'd bring them to the specific units that was asking for them, basically just four by four vehicles that can carry around and a little Assault Squad through mud and shit that they didn't have. And then we'd deliver that shit. And then, you know, we'd spend a night in Kyiv and then we'd get more coordinates the next day. We'd go to another warehouse. We'd fill it up with whatever the fuck was planned for us. And then all this is going on while we are like doing our own shit. Like, last time we were in Zolochiv, they needed salt because their bakery had run dry of salt. They had everything to make bread for the frontline troops except for salt. So, they're like, "We need three vans worth of salt" you know, "We need like 5000 pounds of salt." So, we'd be like moving our salt around to make room for our wealthy patron's shit that she wanted to go to specific units that she had friends in, or whatever that were hard up. You know? So we were just have to like, juggle shit around. And then like, make sure everything fit, throw our 50 gallon drums of diesel on the fucking roof of the car and siphon it out and fill our fucking tanks back up, because you just can't get diesel in Ukraine when we were there. So we had to smuggle in all the diesel for the entire trip. And then, we'd be on our way again. And then we'd eventually get to Kharkiv or wherever, in the far east of the country, get rid of all our shit. And then just like, usually pick up some passengers who wanted to get the fuck out of Kharkiv or wherever the fuck they were, and bring people back and get them out of sketchy situations. And then we'd slowly make our way back to Poland. And we didn't really stop when we were driving. So, some days we drive for like 48 hours straight or some couples of days and then we would take naps and switch out drivers. But on the way back, it was a little more relaxed, like we'd get a hotel or something like in between Kharkiv and fucking Kyiv and try and take showers and get like a good night's rest and then whatever. And then we finally make our way back to Warsaw or Krakow, wherever our next pickup was. We'd rest for 24 hours without doing shit. We would just eat food sleep, nap, like fucking whatever the fuck we felt like doing. Go on walks. Then we'd get another another call from from our person who was funding a lot of this and she'd be like, "Meet me at the warehouse, Tuesday at 1"30 in the morning and bring seven vans this time," you know, so yeah, that's pretty much the cycle that was going on when I was there. Margaret 12:42 Yeah. Okay, so I have a bunch of questions about this. There's so much that's curious to me. Yeah, one of them is like, like, what's in it for this lady? Like, I don't know, if you want to like out her specifically or whatever. But like, it's international solidarity? Is it like... Agatha 12:57 I couldn't tell. Margaret 12:58 Is it just like, we don't want Ukraine to fall because then we think we're next? Is it just the same reason you're there, we just got to fucking help each other? Like, what's going on? Agatha 13:09 So, everything I gathered from talking with this person was that she just like, thought what was going on was super fucked up was like, disgusted that like civilians, were paying such a high price for the actions of, you know, a fascist imperialist government's need to try for a land grab and was just like, honestly disgusted about how little the rest of the world seemed to care about these people who, like, were fucking starving to death and are still starving to death and like fucking living in occupied villages that change hands every couple of weeks, and like, can't get anything because NGOs won't go there. Because Red Cross thinks is too dangerous or whatever. Yeah, I mean, it is but like, that's your fucking job. Like, that's what you should be doing. And it like, came down to like, hundreds and or thousands of like, solo operators who have like these little groups, there's a bunch of us, like, but it's like, hard to...It's hard to say what her end game was. Like, she had a bunch of fucking dudes who, I don't speak Ukrainian or Polish, but there's some words that are the same, you know? And I mean, like, we'd be driving and the radio chatter would be all Polish. And I'd hear like "Americanski,"" and then, "Blah, blah, blah," and then nothing for a minute. And then you'd hear like, "Blah, blah, blah, Pistoleta, blah, blah, blah." And I'm like, what do they got in their van? You know what I mean? But I'm not asking, you know. The most I ever asked was like, the lead dude who took us on the convoys just seemed like he knew his way around a warzone, knew his way, you know, bunch of those motherfuckers were into Brazilian jujitsu. And that's where we like, connected a lot, because that's something I'm into, and they all knew how to handle themselves. They all seem like ex military or something. And one day, I was just like, I was like, "Hey, dude, like, are you ex... It's like, don't answer mean if you don't want to, but like, are you ex military or like current military or something?" And he says, "Kind of." and then walked away. And I was like, "Okay, that's enough." You know what I mean? So like, I don't know what their motivations were. They were like, super not into Russia, I can say that. It like, a little uncomfortable for me because like... and especially the closer you get to the border of the Russia, the more you start hearing terms like 'orc,' and like, stuff like that, as opposed to 'Russian.' I don't know, they had seen more shit than me at that point, had really strong opinions and like, as much as I could tell, they just wanted to, you know, kind of ease some of the suffering that normal everyday people were going through because of the conflict. Margaret 15:47 Yeah. Okay. So that brings it back to like, you know, you mentioned that you, you headed out there hoping to specifically work delivering aid to the anti authoritarian units and stuff. Is that work that you got to continue to do or like? Agatha 16:03 in some ways. So, just to clarify, I originally went out to fight in an anti authoritarian unit made up of English speaking foreigners. That was my my first goal. I had issues with getting my passport in a timely manner. And then there was this like, horrible incident where the unit that had accepted me, they knew when I was coming, they had someone picking me up to bring them to the base and get me situated and fucking geared up. But they're like, "You need body armor. You need a ballistic helmet. You need your own IFAK. You need like, your own fucking compass, you know, basically full kit was needed to be provided by me, because all they were going to....they're going to stick me on a mortar team and I was going to be like, stuck with that mortar team with whatever I brought, or essentially, and then, on my way over there, something happened where the platoon leader was found dead on base. They got assigned a new Platoon leader. This dude was like, "You guys can still fly you're anti anti authoritarian and anarchists flags as a unit, but we're not taking in any more foreigners. And that's that." So while I was on my way there, I was told, you know, "No go on the, on the infantry unit. Blah, blah, blah." So I just like, didn't know what to do. I had like $5,000 worth of tourniquets, and quit clot and fucking chest seals. You know, I had I had ballistic helmets, I had a level four ceramic plates with me. I had more shit than I could carry. I looked like an asshole coming from the Warsaw airport to my hostel, you know. And then I couldn't leave my hostel for like, a week and a half, because I had like, all this gear in there that wouldn't fit in my tiny little safe and like, everyone was like, "What the fuck are you doing with all this shit? And like, why are you here?" And I didn't want to say anything. So I just like seemed sketchy. And then I eventually found a group that was working directly with anarchists fighters at the front. And I was like, "Hey, I brought all this medical supplies. It's basically only heavy bleed stop supplies to treat gunshots and amputations and things of this nature. Do you want it? Like, how do I get it to you?" And they're like, "Yes, totally. One of our people, we'll get with you soon," you know. And this is when I started my waiting game in the hostel trying to like, not leave my shit for too long. And be there waiting for the call. And like a week and a half went by before I got any kind of information. And honestly, I was like, kind of bummed out. This group seemed like they knew what they were doing. Their social media presence was like on point. They were like, just vague enough to like, promote their cause, but like, not giving too much information out. You know, they're just like, whatever. So, I was like, I'll deal with these guys. Fine. I'll give them this medical equipment. And then they just like, totally dropped the ball. And like, they kept saying, someone's going to call me. Every day I texted them. I'm like, I'm sitting on all this crap, I need to get rid of it and be on my way and try and find another way to like, do what I'm trying to do. And it just kept going on. And then, you know, a week and a half. I'd never left the country before I left for this. And I speak no other languages. I'm like super neurodivergent, have like really high anxiety and was just in this foreign city where I didn't understand anything. And just like, every day felt like a week. You know, I was just waiting for my phone to ring and then I could hand the shit off. And like, I had a couple of leads on folks who were like, "Yeah, when you're done doing your thing, like, give us a call and we'll set you up doing some aid work." So I was just waiting and waiting. And then they finally called me. They're like, "Go meet this person at this address. And they'll take all your shit from you." And I was like, "Okay, great." So, I take a fucking cab like across Warsaw, I ended up at this place. I eventually find out it's like, basically like a methadone clinic for like houseless people. I was like, oh cool, whowhoever's doing this also works doing this kind of work you know, but then I just look like a sketch ball, sitting outside of this place with like three fucking duffel bags, waiting for.... Agatha 20:09 Yeah, I have no idea who's coming to meet me. Every person that walked by I'm like, "Are you them?" You know like, yeah, I don't know shit. I'm there. Like the time they're supposed to meet me goes by. I got there like half an hour early because I just wanted to not fuck this up. And then like the time they're supposed to meet me comes and goes and then it's like an hour later. And I call my dudes and I'm like, "Hey, your person's not here yet." They're like, "They're on their way." and then they hang up and I'm like, okay, like literally like four hours goes by of me doing this. Like I'm just like, whatever I'm so bummed and then this like, door flies open to this place and this little person comes out and they're like, "Hey, are you Agatha?" And I was like, "Yeah," and they're like, "Alright, I'm gonna take this shit. Like thanks a bunch." and then like, drags in three duffel bags really quick and slams the door shut and I'm like, fuck like they knew my name, but like I'm pretty sure that was who I was supposed to give this to you know, and then I go back to my hostel and then like whatever. So like, it was like super disheartening to be told I couldn't be in this fighting unit, and then like it was super disheartening to have trouble handing the shit off, but like, in the end, it was probably the best thing that could happen to me, because like, after being there for a while, I was like fuck, "I don't know if I could have been of service in a unit where I have no military training," like, you know, I probably would have been a liability more than anything. So like, Thank God that happened. And then I got hooked up with these people who like, it was like perfect for me. You know, I just drive for 30 hours and then like that was fine with me you know? Like I traveled the country a million times as like a dumb useless punk. Like this was like the same shit, just like felt better because I was like helping people you know what I mean? Margaret 20:09 Thousands of dollars of gear. Agatha 20:36 For everyone that's listening. That's how we that's how we know each other, is being dumb, useless punks traveling the country. Agatha 22:02 So, I just applied whatI knew about like traveling and being comfortable being uncomfortable with like, doing shit and it was like a perfect fit. So, I originally went over to do that. Yeah. And then it switched to this. And then I was only there for like six more weeks. But, I did a bunch of shit while I was there. And, you know, I will probably get into it later. But, I needed to do like a lot of trauma therapy once I got back and like, it's been a year and I just felt comfortable enough to buy another plane ticket there and I'm on my way back. But this time, I don't have to figure anything out. I already have a crew. We have a fleet of nine vehicles. We have deliveries lined up for fucking months. So it's like, I can just jump right back in you know, and like, it's just nice when you like hand a bunch of fucking hungry people food or you know, yeah, like. And that's the thing that struck me most is I went out there as an anarchist and then while I was there, I kind of just turned into like a humanist. I was like, you know, I just didn't give a fuck who I was working with anymore. I was like, "Oh, you're hungry and you need food. I'm gonna bring it to you," and it didn't matter to me anymore who was picking it up. You know, I even worked with some known fascist units who supposedly kicked all the Neo Nazis out, and anti Semites got kicked out, but they still have unscrupulous pasts as like street gangs and stuff, but like, you know, I was bringing them stuff to like, keep people alive. I didn't. I just stopped caring, you know, about political affiliation and shit. Margaret 23:39 No, it makes sense to me though, like, because one of the things that has been so interesting to me about like studying disaster stuff and disaster responses, right, are these like, you know, there's this moment that I wasn't there for but sticks in one of my head, my head is that one of my best friends. I've probably mentioned this on the show before, but one of my best friends is this, you know, crusty traveling punk kid who went to go do flood relief in a place that you could normally drive into, but could only be flown into. And the people who were flying in, were all of these people with like, tiny airplanes, which means rich libertarians. And you know, and so my friend is like talking about being like, and you know, and they're nervous person, and they're in this tiny airplane driving and like flying into a storm with this, like, random libertarian guy, right? And it's just like, and they were fine. And they landed and they delivered supplies and they got food out and got stuff out to people who needed it who were trapped and hungry. And I think that's what's so interesting about disaster, whether it's, quote unquote natural, like the accelerating climate disasters, or, you know, the invasion of an imperialist power into your country is just this like....like the goal isn't to help anarchists. The goal is to help people who are being destroyed by an imperialist power. You know? Agatha 25:05 Yeah, exactly. Margaret 25:07 It's interesting to me, because I do have I have a...like it's like cool, right, supporting the anti authoritarian unit specifically. It's cool and like anarchists organizing this is cool, but a lot of that is like...well, I'm excited that an anarchist is at least one of the drivers of this organization that you're working for, you know. Like you. You know? What is it? What is it like interacting as an anti authoritarian person within this like...you know, yeah, you have this like, rich industrialist lady who's just like, pouring everything and all kinds of risk into just providing things for people and I presume you have this very...like is it this melting pot environment. Like, what is it like socially? Agatha 25:50 It's fucked up, man. Like the guy I got stuck with like, when the group I started driving for wanting to vouch for me, they're like, "We have a solo run. It's like not very sketchy. We're not going that far east. We're just going like outside of Lviv. It's like a fucking shit ton of sanitary products. And then like, you're going to come back to Częstochowa and you're going to fill up the van full of strollers and bring it to this orphanage that's only run for orphans that were victims of losing their parents in fucking Bucha you know. Margaret 26:21 Well, it better be anarchists babies, because otherwise they don't deserve strollers. Agatha 26:24 Yeah. But, the fucking guy picks me up and he's wearing a fucking Black Rifle Coffee Company t shirt. Margaret 26:30 Oh shit. Agatha 26:31 And I was like, What the fuck is this? You know? And I was like, this sucks. And I was like, cuz I knew they weren't going to be anarchists. But I was like, this dude is wearing just a straight up fascist companies t shirt. Margaret 26:44 Yeah, this dude wants to kill you in the United States. Agatha 26:47 Yeah, well, he's from Canada. And that's the thing, like, his view on it was like totally different. I was like, you know, after like, nine hours in the van and like 18 cups of coffee. I was like, "So what's up with your shirt, dude?" And he's like, "Well, I just really like their coffee. And like, they have pictures of guns on their shit. It's like good advertising." I was like, "You know those are the assholes who like bailed out Kyle Rittenhouse, right?" and he's like, "Who the fuck is Kyle Rittenhouse." and I'm just like Jesus Christ. And, it was just like, super fucked up and like, we had like really long conversations about what like being an anarchist means to me. And you know, the more we talked, the more I realized our like end goal was exactly the same. He was like, just a farm boy from from South Central fucking Canada who grew up on a fucking....what's that stuff called? I don't want to say the name of it cause I hate it. And there's another name for it. He's from a canola farm. And he joined the military when he was young. And he's like....I'm a pretty tall person. I'm like 6'2", and he's like three inches taller than me, built like a brick shithouse.Just look like the dude you don't want to run into as an anarchist in like a war zone wearing a fucking Black Rifle Coffee Company t shirt. But the more we talked, the more we were just like yeah, we just want to fucking help people. And like that's it. Like, I just don't care anymore. Like it basically came down to everyone in our group wanted to ease some suffering that was happening at the behest of like, fucked up agitators who were acting on like imperialist like logic, you know? And yeah, that's basically what it all boiled down to. So, like I went there as an anarchist trying to support anarchist endeavors....and because they were helping just normal people, right? And and then it just turned out like, you know, circumstances change. They didn't...like multiple groups didn't want any more foreigners. You know, I was never given explanations as to why....Someone said it was because my social media presence was too hard about going to Ukraine, and they didn't want people getting their spots blown up. But, I was like literally all I said is I'm going to Ukraine, bringing medical supplies to anarchists units. And if you want to donate, donate here. I gave zero information on what unit I was delivering to, where I was going, who my contacts were. It was like vague as possible to just get donations, so I could buy more tourniquets. That's like all I was doing. That's that's the most explanation I got, which never added up. Margaret 29:19 They must have had their own shit going on. There must have been like something that had happened recently or like something within the internal structure where they were like trying to hold on to their anti authoritarian unit within an authoritarian structure, you know? Agatha 29:34 Exactly. And I later found out like, once I was back from a couple runs, and the unit that had originally accepted me, and said no more was like, "Hey, we got a guy coming to Warsaw and he wants to meet you." And I was like, "Okay," and it was just like the most giant man I've ever met and he was just like, decked out in like fucking workout gear and he's like, "I'm coming from the gym and I only got an hour I'm going back to the gym. I'm with this unit. I'm on leave blah, blah, blah." And I guess what it was was like, you know, it was other foreigners who were in the group who were posting shit online they shouldn't have been, you know, and one example was, there was someone who posted a picture of themselves outside of a building being like "Training for the good fight," or whatever. And whatever fucking Russian like ops that we're monitoring social media saw a picture of the building, did a bunch of fucking research, found out where it was, what the building was, and fucking a missile strike happened and like 500 volunteers died or some shit. Agatha 30:39 It was like super fucked so like, I totally got it, but like, and I wasn't gonna argue with them, you know what I mean? I was like okay, I'll find something else to do, but like that's not me. And that's not what I'm doing, but like, whatever I'll try and help out some other way. So, I think that's the kind of shit that was happening that led to me not being invited into these like strictly anarchist groups, because I mean, you know, fucking anarchists. Everyone's like security culture. Like the feds are like bugging my phone because they want to know what dumpsters I'm hitting or whatever. You know what I mean? It's like... Margaret 30:39 Oh my god. Margaret 31:12 Only here, it's like they're actually throwing missiles at you. Agatha 31:15 Exactly. Exactly. So I was like, I get it but, like whatever, so I think that's really what it was and like I couldn't fault them for it. I was like whatever, but yeah, I'm just some like scumbag from America anyways. Like you don't know me. Like you don't know if you can trust me like. Sure, I have tattoos on my face, but like whatever. Like you know what I mean? Like yeah, so I got it but like, I don't know. I'm kind of rambling at this point. I'm gonna let you direct the conversation a little more. Margaret 31:39 No, no, I'm really curious about all of this kind of stuff, like I'm very curious and I think the audience will be curious about....I mean, even down to like how do people take you as this tall, you know, person who presents somewhat masculine, but often has a non masculine name, has face tattoos, doesn't have like, you know isn't like mister Mr. heterosexual cis man, but also is like a tough as fuck looking, like face tattooed punk, right? Like, what do people make of you? Like how did that go? Agatha 32:18 It just depended, you know, some people were just like, "Who the fuck is this guy?" Like? Yeah, cuz I mean, I do have a lot of visible tattoos, but just to like, give it some context. Like my tattoos are like of puppies and like, I have a giant heart on my throat. You know what I mean? They're not like tough guy tattoos. Aside, I have some air 15 magazines tattooed underneath a "Do not resuscitate," tattoo on my chest. My chest looks like some pre-schooler went to prison and got tattooed or something. It's like light hearted. There's like skulls and puppies and yeah, rifle parts and like a 'do not resuscitate,' banner and like shit, but like, that's not stuff people generally saw. But they'd see my heart tattoo on my throat and my shit on my face. And like my hands were all blacked out. And you know, people were either like...A good example is like, people either didn't say anything, or they'd be like...like, one time we were in Kyiv we're kicking this grifter who had gotten caught up in our shit out. We needed like five to six hundred litres of diesel that we had shoved in his van. We needed to get that out before we kicked him out. Because we knew he would just steal it from us. I mean, I found out the guy had gone through my phone when I was sleeping. There was like links to his aid organization to the like, PayPal link on my phone. Like my Safari was open. And it was like, please enter your Paypal password to donate to this group. And I was like, "Who the fuck is this group?" And then we realized it was this guy and we needed to kick his ass out. But like, whatever, we didn't know where to kick him out. Like we didn't know if he was gonna get violent with us. So we picked like a super populated spot and Kyiv which is where we were at the time. And we're like, "Meet us here," you know, "at this parking lot for this fucking train station." But the parking lot was closed. And, it was like, all the spaces were empty, but we couldn't get in, and there was this like drunk ass dude wearing a body camera in this little booth. And he was like....we just went up and we're like, "Hey, are you the one watching this parking lot right now?" And our interpreter could not understand a fucking word this guy was saying. He was so drunk. And it's like the farther east you go like, the more the dialects change, so like our interpreter was 18 years old from from Lviv. He had never been this far east, you know, which Kyiv isn't even that far. But like, you know, if you've never been to Kyiv really and you get there and then there's people from the opposite end of the country who you know, I mean, it's just like, there's a big disconnect with with local dialects. He could only you know, figure some shit out. And we eventually paid the guy like a bunch of grivna not to fucking, just do this deal real quick. We're like, "Hey, we'll give you this wad of cash. Just let us park here for like 20 minutes, this guy is going to meet us. We're going to move a bunch of shit around from Van to van, and then we'll be out of your hair," and he's like, "Alright, fine." But, he was like fucking hammered. And he would not leave us alone. And he was like, uncomfortable drunk where he was like in our faces, like breathing on us, asking us questions. And our interpreter was trying their best to like, fucking answer. And then it just got hot during the day, and I went to take my shirt off, and all my tattoos are black line work. They look like fucking prison tattoos. And this guy, I see him catch my eye as my shirts about to go over my head for a second. And I pulled my T shirt down real quick. And he's like, "Ah, prison." And I was like, "No, no, no, no, not prison," and he's like, "Prison." And I was like, "No, it's not prison," and the guy just wouldn't shut up about it. He just kept saying "prison" to me and like, give me the 'okay' sign with his hand. And I'm like, "No, dude," you know? So, it's like, it was like, stuff like that. And then other people just being like, "You're a fucking freak American? Are they all like you", kinda shit. it was just like, I don't know, it was super weird. I got some shit for it. But like, most people, like I would talk to them for five minutes. And they'd be like, "Oh, you're just a person who wants to like, do shit." You know what I mean? But then, the more I got into this shit, and the more I was like, getting deeper into the east of the country, like, it got like, less and less about personal identity and what you what you were presenting to the world, right? Like I am an assigned male at birth guy who's six foot two inces and like, I have tattoos everywhere. And I carry myself like, like, really confidently, because I'm a martial artist, and blah, blah, blah. I'm just like...and I don't take shit from people like...It just was like a little easier for me to get by. But like, I was with this really well known fascist unit, who was giving personal protection to this trans woman, who was in the east of the country and had been there for months. Like she had gotten fired from her news organization because she started using the term 'Orc' in her in her pieces, and they're like, "You're no longer unbiased." And she and she was like, "You can't be unbiased. If you've been out here," like, "These Russian soldiers are fucking pigs. Like, they're like, they're raping people. They're killing children. They're doing all sorts of shit. They're bombing schools. They're bombing hospitals, like, and all these people could just shoot their officers and come across the line with a white flag. And the Ukrainians would treat them fine, right? Like yeah, but they're not doing that they're doing what they're told. And they're being complicit in these atrocities, blah, blah, blah." So she was like just going around doing all these pieces and her personal protection unit was all these supposed fucking homophobic, you know, fascist pieces of shit and granted, I never got drunk with these guys. I didn't have beers with them. I don't know what they really think but, they thought what she was doing was important enough to like give her a pass, you know what I mean? And like protect her, and get her to these like places to interview these people. And that's the kind of like, shit I mostly ran into, was like, you know, you don't have to agree with me right now, but we have a goal in mind. And once the Russians are gone, fuck it. We'll figure out our differences later, but like right now, like were chill, and I got like pretty hopeful about it till I met this like, platoon leader in an infantry territorial defense unit who, after...we were bombed at one point our fucking vans got destroyed, and we were looking for a mechanic to fix our shit, so we could get out of the east of the country. And this dude who spoke perfect English came up to us and was like, "What are you doing? What are y'all doing?" We told them what was up and he was like, "I'll try and find a mechanic. I got a mechanic buddy, like right around the corner, blah, blah, blah." And then while we were waiting for a callback, me and him just like got some coffees and like, talked for a while it turns out, he's like, uh, you know, he was a fucking, like, a human rights activist who was a lawyer forever, and like, graduated college in '92, and started his own organization to help like, LGBTQ refugees from like Belarus and shit, you know? And I mean, he was like, super fucking cool. Yeah. And the guy just eventually was like, "Yeah, I went to school at a military accredited college. So when I joined the territorial defense units, they're like, "You're an officer. You're, you're in control of a whole platoon,"" and he like, tried so hard to convince them that he was not their guy. Margaret 39:44 That he has the wrong platoon. Agatha 39:46 Yeah, he's like, "No, dude, I don't know how to fight blah, blah, blah. These are all like seasoned infantry men that I'm supposed to be...." So he's like, "I just fucking started listening to the most experienced dudes in my company and like, like, let them decide basically," and then, but like I got talking to him, I was like, yeah. You know, I introduced myself to him as my birth name. And he's like, yeah, you know? And then we started talking and it became apparent that he was not straight and all this other shit. And I was like, "Yeah, like, we've been working with this one group," and he's like, "Oh, yeah, they're bad news, you know?" And I was like, "Are they, though? Because like, they've shown me to be like, pretty decent to like, a lot of marginalized folks. As far as I can tell. I don't know." Yeah. And I was like, "I go by Agatha in the states and like, my crew calls me Agatha. But like, I do feel scared enough to not introduce myself as Agatha to the people in this unit, because they're, they're staunchly fascist, right? Like, you know, they, they're not into it." and they're like quick like without missing a beat they're like, "Oh, yeah, no, do not introduce yourself to these motherfuckers as Agatha. They're like, they did get rid of a lot of antisemites, they did get rid of a lot of overt racists, but there's like homophobia is still a huge problem in the Ukrainian military and population in general. It's very conservative. And so like, he like really opened my eyes that like, I was like, "Yeah, we're all in this together. Like, who gives a fuck your political affiliations? You know?" And then he was quickly like, "Yeah. No, people still disappear all the time during wartime. You know what I mean? Like, yeah, watch your fucking ass and like, keep doing what you're doing. But like, don't get too comfortable with these people." And it was just like....It was hard because like, I fucking was just feeling good about, working with people of different ideological backgrounds. And it felt good to just feed people and have this shared goal. And then just to be like, brutally reminded that, like, that's not actually the case. And it could get backwards really quick. You know what I mean? If I like yeah, said the wrong thing to the wrong person. Like, I have like an antifascist action pin on my hat. It's just like, you know, the little two black flags. It says "Anti-fascist action." He's like, he's like, "I wouldn't wear that, you know, I just wouldn't. you know, and I was like, "Okay." I listened to the guy, you know, he's fucking awesome. And I like, kept in touch with the dude through Telegram, and it was fucking on and then he got captured by the Russians, and he's still in captivity, and like, they're trying to act like he's a super Neo Nazi, because, like, that's what they do to human rights...and you know, people who are obviously leftist who get who get taken prisoner. But, you know, he's facing fucking 12 years in prison in the Donbas now, you know, and I'm just hoping, because he's an officer, they're going to do a prisoner swap, you know, but they're like not into it. And I, you know, if I had weird questions, I'd ask them, and then they'd always give me like, a nice response. And, you know, didn't treat me like an idiot American. They're like, yeah, "You just don't know the culture, blah, blah, blah." So, now what? Margaret 42:48 Yeah, that's, that's a really good...it's a sad, but it's an important counterpoint in this conversation we're having is to realize that like some of the civility between these units is probably short term, probably a veneer, and like, probably necessary veneer to drive out the invading force, but it makes sense to not to get too comfortable with it. And that's sad, but it's interesting because it's like, I hold, perhaps naively, that a lot of center Right, people really are distinct from far Right people, and like, have, you know, some really good ideas in terms of "Hey, what if we all left each other alone and sometimes took care of each other?" And it's like, easy for me to say as like someone who lives in a rural center Right area, but not a far Right area. And that's an important difference, you know? Agatha 43:45 Yeah, but I think that's like a pretty fair assessment too, of people out there. It's just it doesn't...you just can't count on that for long because even though like you could be a center Right, dude, and then you spend nine months in a fucking infantry unit full of fucking mutant goons who are espousing all this hate and it's easy to go from center Right to far Right, you know? Margaret 44:05 Yep. Yeah, no, totally. And it's...Yeah, fuck. Well, to go from that light subject to another really light subject. You mentioned that you were attacked, your caravan was attacked. Agatha 44:20 Yeah. Margaret 44:21 Do you want to talk about that? Do you want to say what happened? Is that right? Agatha 44:24 Sure. It's hard for me to just like, do it kind of like, you know, like, give you the synopsis. Like I kind of rant about it when I start going into details, because I start going into like lizard brain thinking about how I felt while I was there. So, with the caveat that like I want you to like be like, "rein it in," if you're like...if I'm given too many details, or if I'm going off on a fucking rant or whatever. Basically, we had done....we had been driving for like 48 hours on and off. We left Krakow. We got to Lviv. We dropped a bunch of shit. Picked up a bunch of shit. Got to Kyiv, dropped off a bunch of shit, picked up a bunch of shit, and this all started like insane. I was at the fucking ladies warehouse, loaded up like usual. And that grifter dude we were working with....so his thing was, he was working with the....What the fuck is their name? Not the Rotary Club. They're like something like that. The Lion something? Do you know what I'm talking about? Margaret 45:28 Yes, one of those like weird things. It's like not the Masons, but it's basically the Masons. Agatha 45:32 Yeah, t's not the Masons, but it's kind of like the Masons, and they do like whatever.....So, he, I don't know how he fucking did it got a bunch of funding for them, bought like two brand new vans and was out there, under the auspice that he was working for them. But he had all these weird things he was doing that he wouldn't share too much information on. And he had a Land Rover and it was one of those fucking British Land Rovers with a steering wheel on the wrong side, or the other side, not the wrong side. Margaret 46:01 When we're British people, we can say the wrong side. That's fine. Agatha 46:06 So, we're loading up all the shit. I'm waiting for the rest of my crew to get there. We got there a couple hours early. We get all loaded up. And I'm like, "Hey, person who runs the shit, like, what can I do to be of help while I wait for other people? Do you have shit that needs to get like moved around in the warehouse? You know, like, what do you need for me? She's like, "I need you to get this fucking guy off my back. He won't leave me alone. He wants to leave right now. And I told me, he's got to wait till the rest of the convoy gets here so you all get to the border crossing at the same time when you're supposed to. And you can give this paperwork to the guy who needs it." And I was like, "Okay." So the guy won't shut up. Eventually, they get in a huge fight. He says, "We're leaving," and looks at me. And I was like, "What?" and the lady's like, "Alright, good luck crossing the border," you know. And he's got his own van and he's like, "You're gonna drive this Land Rover full of shit by yourself. And you're just gonna follow me to Kyiv where we drop this off to a unit of American volunteers who are all ex military. And they're working on their own outside of the Ukrainian military. And they need a four by four vehicle to get in and out of like weird spots." And I was like, "Okay, fine." And then. So, I call the main planner of my group and I'm like, "Yo, dude is trying to be sketchy. He got in a fight with Lady. They're at each other's throats. He just wants us to leave. She wants us to get the fuck out of there just so she doesn't have to deal with like, this, like sketchy male bodied person yelling at her. She just doesn't need this, you know?" And he's just like, "I'm so sorry to do this to you. But like, just go with him. Just like get out of there with him, like, help him out. We need his van space once we hit Kyiv because we have more supplies than we can bring to Kharkiv in the space we have. So, I was like, "Okay, fine, whatever." And this guy like we eventually....She looks at me, she gives me a big hug. And she says, "I'm so sorry about this." And I was like, "Sorry, about what?" And then she looks at the guy and she's like, "Have fun crossing the border," and handed him a thing of papers and like was like, "See you guys." And then she's just like, "Please stay safe, Agatha." And I was like, "Okay." And and then I was like, I don't know what's going on. This dude throws a radio on my lap. I had never used a fucking CB radio at this point in my life. And he's just like, he's like "Try to keep up." And then he like fucking takes off on me. And I was like, What the fuck, and I'm like, racing to keep up with him. But, he's passing all the semis on the highway and I'm driving a right handed vehicle. I have to get all the way in the other lane to see if there's oncoming traffic, which is sketchy as fuck. I have never driven one of these things. It's still like normal driving lanes, you know what I mean? It's just a different driving side on the car. And it just was like the most stressful thing that's ever happened to me. For four hours trying to keep up with this guy. And then we finally get to the Ukrainian border. We're well outside that window of time she told us to get there. And he's like, "Don't worry, let's skip the line. Let's drive on the outside of the line in this like break down lane and get up to the gate and I'll get us through." And I was like, "I don't think that's gonna work, bro." And he's like, "Whatever." We get all the way up there. I'm still sitting in the car. I see him arguing with the border guard. The border guard's just pointing to the back of the line and then I'm like, "Fuck," and then eventually he's like, "Oh, we gotta try again blah blah blah." And he like turns around and we go...we do this like three times. He argues with three different border guards. And eventually we just have to sit in line for like eight fucking hours like Lady told us we were gonna have to do if we didn't fucking wait and he's all griping about it and blah blah. Yeah. And I'm just like I want to be like, "I fucking told you so." I don't like this guy already. He's like, super macho, has no regard for other people's emotional like capacity for anything and it's just about him and blah blah blah and he's got to get this vehicle to this unit or they're fucked and blah blah blah. We finally get through. He does the same shit, and I don't know if you know anything about Ukrainian roads, but they are that was fucked up roads I've ever seen in my life. Like, before the war. Like there's just like...they are fucked up. It's like the main highways are just packed with potholes that like, are just so devastating when you hit them. You're like, Oh my God, and like, he's just flying down this highway and like, he's like, "Keep up," like I keep hearing in the radio get more and more staticky. He's like, "I can't see you back behind me. Like keep up. Blah, blah, blah." And I was like, "Dude, you're going too fast. Blah, blah, blah. We do this for a whole day. And we get to Lviv and then whatever....I missed a detail. It wasn't Kyiv we were going to deliver this vehicle to. It was Lyviv, which is much closer to the border. We get we get to Lviv, and he's like, "We gotta meet this fucking dude, and hand off this fucking vehicle. And I was like, "Okay, fine, whatever." We finally get to this gas station. And there's these two dudes dressed in fatigues with their weapons out, like totally out of place, and they're holding gas cans. And he's like, "There's my dudes." And I was like, "Okay." Margaret 51:16 From the Lions Club or whatever? Agatha 51:18 Yeah, yeah. Well, no. He didn't tell me how he knew these guys. He alluded to the fact that he was in Afghanistan for a while working with Blackwater motherfuckers doing the same shit, but just equipping Blackwater units like not other stuff. So, I was like, alright, this dude's got sketchy friends. Whatever. Turns out this dude doesn't know the fighter at all. They met through the internet. He's not donating this vehicle. He's selling it to them and then fucking dudes like all sketched out because he looks at this Land Rover and is like, "So, this thing's good to go. It's all like mechanically sound?" And dudes like "Yeah, it's good. I had a mechanic look at it and everything in Poland blah, blah, blah." And I was like, "Yo," I could not shut up. I was like, "Yo, I drove this thing from fucking Krakow and it is not sound. Like you at least need new tie rod ends." Like I'm a proficient mechanic. "I was like, You need new tie rod ends and or like fucking drag link for your steering unit. And like, I don't know if you've looked at the back hubs, but like, they are rusted to fuck, like, Good luck getting the rotors off of the hubcap kind of shit. You know what I mean?" And he's like, "Well, what the fuck, I can't use this dude, we already paid you. I told you this was to get infantry units into hot zones, to do some sketchy shit. And to get out. Like, you told me this thing was going to be mechanically sound, and it just wasn't and like, blah, blah, blah." And I still had my whole kit from when I thought I was going to use my time there fighting. So, I feel bad for this guy. And I was like, "Hey, do you guys need any like, PPE or anything for one of your members of your unit? Like, he's like, "Yeah, the Russians just overran our base. And we lost everything. Some of our dudes are wearing jeans and sneakers." And I was like, "Okay, I got like, three sets of BDUs. I got a pair of combat boots. I got knee pads. I have a fucking thermal imaging camera. I have weapons sights. I have, like, you know, weapon attachments," all this shit. And he's like, "Oh, fucking A. Thank you so much." And he's like, you know, "Fuck this dude. I don't know how I got mixed up." I was like, "Whatever, just take all my shit. And we're gonna get out of your hair. I'm so sorry this happened. Yeah, blah, blah, blah." We get to Kyiv. We kick them out like I told you we did with a drunk dude. And then. And then like, another day later, we finally ended up in Kharkiv. We get rid of all our shit. Margaret 53:32 Okay, how much of this is lizard brain? I'm just... Agatha 53:35 A bunch. But I'm I'm at the point now it's starting to matter. Margaret 53:40 I appreciate that you're telling like a hitchhiking story. So it's like, it's very relatable to me. Yeah, please continue. Sorry. Agatha 53:46 So, we're in Kharkiv. We've given up all our shit. We've re-supplied and done that shit like four times. We have one more delivery to do. And then we're going to head back to Poland. And.... Margaret 53:57 Wait, who you with at this point? This is the rest of...The rest of your crew has caught up with you at this point? Agatha 54:03 Yes, yes. The rest of the crew has caught up. They caught up with us after we handed off that vehicle to the unit. And they caught up with us in Kyiv. We did a bunch of drop offs. We did a bunch of pickups and then we all drove as a unit after we kick that dude out to Kharkiv, which is, I don't know. It's like 20 miles from the Russian border or something like that. I could be wrong. It's not far. I mean, while we were there, you could hear artillery going off in the background. Yeah. You know, whatever. So we have 75 IFAKs to deliver to this one particular unit who, we had another wealthy benefactor, those two were in contact, the unit and this wealthy benefactor, this wealthy benefactor said "I know these people who will deliver it to you," and that was us. So, we have 75 IFAKs. I don't know if you know what an IFAK is. Margaret 54:51 Yeah. Individual first aid kit. It's a trauma kit for gunshot wounds, for anyone who's listening. Agatha 54:56 Yeah, it's got a tourniquet. It's got some quick clot. It's got a chest seal. It's got like a aluminum brace, it's got all the shit you need to like, stop some bleeding for 20 minutes to hopefully get them to like a more well equipped place but... Margaret 55:08 They save a hell of a lot of lives. Agatha 55:10 They save so many lives and they're so important and like...So, we were delivering 75 of those. We're meeting this unit at this restaurant. It's one of the only restaurants open in in Kharkiv that we can find. There's like three Ukrainian families eating there. And we just start hearing artillery getting closer and closer to us. And we're like, "Fuck, this is getting scary." Like, we start feeling it in the table. Our glasses start shaking. And my friend with the Black Rifle Coffee shirt, he's like, "Fuck, they're bracketing us." And I was like, "What is that?" And he's like, "It's when you have a, you know, an end goal in mind of where you want to hit. And then you like launch a round of munitions. And through whatever means whether it be like drones or whatever you see where it hits you readjust your calibration on your aiming device, you launch another round. It gets closer and then you're getting closer to your target, right? Yes, I think they're bracketing us." The shit is getting closer and closer, because we're at the base of the Soviet monument. And it's like a 100 foot tall statue of a Ukrainian dude wearing like Russian combat gear from World War II and it's like, supposed to be a Soviet monument to people who lost their lives fighting the Nazis in World War II, but someone had climbed all the way up there and taped a huge Ukrainian flag to their to their gun and it was like...it just seemed like that's what they had to have been aiming for because it was like a big "Fuck you," to Russia, you know what I mean? And yeah, so we're like okay, and you know, we're trying to get our social media presence up so we can get more donation so we ended up with this fucking Tik Tok'er with 2 million followers with us. And he doesn't want anything to do with us most of the time. So, he got an Airbnb. We're getting bracketed. We're waiting for the.... Margaret 56:56 This sounds like a movie. You've got a Tik Tok guy with 2 million followers.... Agatha 56:59 It's insane. It was fuckinginsane and we're waiting for this military unit to come pick up the 75 IFAKs. We have our food boxed up. We're like as soon as we give these dudes this shit we're out of here. We're leaving Kharkiv. And then someone's like, my buddy, who's the main planner is like, "Yo, y'all need to go get dude, he's at an Airbnb, like fucking 10 blocks away." So, we're like, okay, so me and Canadian infantry dude get in a van and we start like going like 110 kilometers through the middle of Kharkiv literally shit blowing up all around us. We're trying to get to this fucking dude. And we finally get there. And we're like, "Where are you?" on the phone? We're like, "We're down here. Get the fuck in the van." He gets in the van. We throw him a fucking vest with like body armor and give him a helmet and we start racing back to the fucking restaurant and it's just like...there are just like artillery munitions going off all around us. it was fucking terrifying. And then we finally get to the park where this monument is that and we have to park, walk through the park itself to get to the restaurant where all the rest of our crew is at, right? So, we park our last two vans we have in the convoy. Me and Tik Tok'er get out. Dude I'm with gets out. Se start walking across the park and I mean even with....like people are just used to artillery going off in the city right, so there's like old people everywhere soaking up the sun on benches and shit like that and people just like ignoring it and then we get like about I don't know 30 minutes or 30 meters into the park and then all of a sudden I hear this explosion really close behind me. I turned around I see all the glass in our vans get shot out all at once. And then something blew up like right next to me and I lost consciousness. I woke up on the ground. Tik Tok'er was confused and like we both didn't know what was going on. I couldn't hear anything. All I heard was like the biggest like ringing in my ears I've ever heard. My chest hurt from the impact of like the sound wave hitting me. Agatha 59:10 Yeah, yeah, I couldn't breathe. I was just like freaking out. I just started like grabbing my body armor and seeing if there was like blood anywhere. I was like whatever, and then I realized I'm okay and then I'm like, "Fuck all the windows of the the restaurant that my buds were in are blown out and it's like fucking on fire. It was like....so I run over there. Buddy is trying to....military dudes trying to tell me to get back in the van. I was like "I'm not getting back in the van, like that things like destroyed and blah blah blah." And so I just follow him and we both run in and he's just like "Boys, boys, where are you?" and we hear them yelling from the kitchen and everyone that was in the the dining hall went to the kitchen and we're hiding behind this like knee wall and the military unit we were supposed to give this shit to was there and I was like "Fucking great. Like, there's someone who knows what they're doing." Yeah. And everyone's like, "Are you okay? Are you okay? Like, what's going on?" And Meantime, there's still rounds hitting all over the fucking place. And he's like...everyone's like, "What do we do? What do we do?" And I was like, "Yo, we got 75 IFAKs in the van right now. And there are people like hanging out with like, missing limbs and like, screaming, bleeding everywhere outside, like, we need to get out and try and help people. And I tried talking to the medic who was with the unit that we were meeting up and he just like, didn't understand me. The interpreter was having a hard time. They lost their shit, you know? Yeah, everyone's freaking out. And like, I'm just trying to get these people to follow me. I was like, "Just come to the park. Like, we know how to put tourniquets on. We know how to pack wounds, like, please, like, let's just do this." And everyone's like, I don't know." A few of the people in my crew were like, "Yeah, let's do it." And then the people of this unit, like pissed me off, they're like, "No, we should just hang out here till the artillery barrage stops." And I was just like, "Fuck you. I'm going." And then like me and four people went out. We ran to the vans, we fucking grabbed all these IFAKs and then we just like, dumped them on the ground and started ripping out tourniquets. And then we split off into different little teams and just started fucking tourniqueting people who were bleeding everywhere, like this one dude was like missing limbs and was just like screaming. It was like the most intense thing I've ever experienced. He ended up fucking dying. Like, it was just like, so nuts. And that went on for like, 25 minutes, 30 minutes. And, um, and my personal IFAK that I wore on my chest rig was like, that was the first one I ripped off, you know, and yeah, tourniqueted at this lady was bleeding heavily from her inner thigh and I was scared it was like a femoral artery or something. And, after like, 30 minutes, this ambulance shows up. And they're just creeping by the park. They're not stopping. And I was like, "Fuck," and I like, stopped what I was doing because I had treated everyone I could find at this point. And I was like, in like, crazy mode. I was like hiding under a tree that would provide me no protection from an artillery round, but I was like, freaking out and then I saw them ran up. I was like, "Yo, you guys gotta get out of here. There's people bleeding all over the place. Blah, blah, blah." And then the military dude, I realized the medic had never even opened his fucking med kit. He was just standing there with hi AK watching us like tourniquet up...watching us of civilians like tourniqueting up all these people, and then fucking whatever. They're like, as soon as the EMTs arrived, they eventually get out. They start tending to the people, we had been triaging. And then the military dudes just like, "Alright, we gotta get out of