I'd been rather low on food for a while needing to wait to get paid again, which I did today, and will be again tomorrow, as I get two payments every alternate fortnight. One is due to my knee issue, getting glass through the joint, and later having it stamped on during my recovery, it's never been right ever since, and surgery on it only made things more unpleasant. It did stop the joint-locks and sudden collapses that I used to get, unpredictably and doubtless in the most inconvenient moments, but at the cost of nerve damage, that left my left leg without feeling from about a hands span above, to most of the leg below the knee on the outer side, well, some sort of vestigial sensation, but major-league fucked in every sense.
Similar to what remains after a local anaesthetic, but not so potent, so I can still feel a burning paraesthetic pain, that opioid painkillers for the most part, as expected, only poorly deal with it, with the notable exception of methadone, which has some weak NMDA receptor antagonist effects, and NMDA type glutamate receptor antagonists like ketamine, or the far longer lasting, less psychically squirrely and rather unique partially voltage-gated antagonist ligand memantine, with it's relatively weak binding and rapid on-off binding kinetics at the magnesium binding site situated in the NMDAr ion channel pore itself, meaning it selectively binds and inactivates only activated, open NMDAr ion channels, leading to a selective blockade of overactive NMDA receptor mediated activity, important in neuropathic pain, whilst not impeding normal function of the receptor type(s). Coupled with a very long duration of effect, days even after a single high dose, and minimal psychologically twisting dissociative effects such as are produced by more traditionally binding non-competitive and uncompetitive antagonists of NMDARs, such as ketamine, PCP, methoxetamine for example, really high doses of memantine CAN cause such a state, but they must be very large indeed given the unusual binding kinetics of memantine. The arylcyclohexylamines can substitute the purpose in low, carefully tailored dose regimes, but where PCP and ketamine and their analogs are the NMDAr-type glutamatergic analogy of a monkey wrench, memantine, could be thought of as a fiber-optic guided surgical laser scalpel, or a sniper's rifle shot compared with an old fashioned naval cannon loaded with grapeshot. Elegant in every respect, it's quite the miracle drug in my experience with it.
Even capable of fighting opioid tolerance whilst enhancing motivation, having antidepressant effects, and when used to combat opioid tolerance it performs with just such a surgical efficiency on multiple simultaneous fronts. It actually slows development of physiological tolerance and dependence not yet incurred to the opioid in use, whilst stamping down HARD on tolerance already incurred, virtually wiping out the horrible experience of acute physical opioid withdrawal if used during such a state, and even combating the psychological hunger the reinforcing effects of opioids bring as bane along with their blessings of relief from otherwise intractable pain, increased tolerance for otherwise truly awful drudge work, ability to hold out against stamina-sapping long sleepless periods of work that must be done and done right, without delay.
I honestly cannot fathom why such a drug, with memory-enhancing effects thrown in along with the bargain, low physiological side effects, a simple chemical structure derived from a methylated aminoadamantane skeleton, and not much else, a few Me groups on some of the adamantane core heterocycle, and an amine group, come together to make this surgical fucking miracle worker of a compound....cheap for industrial production no doubt, isn't being explained and offered to each and every single patient of a GP or in hospital who is a candidate for requiring longterm opioid prescriptions.
I find it absolutely astonishing it isn't, and that it's hard as hell to get, being primarily assigned as a very poorly effective sticking plaster for doomed alzheimers hollowed out shells yet to find release in death, I've gotten the support of the GP who runs my surgery, to get on it, after putting together a presentation on the general purpose, the incidental boons gathered from it's positive side effects, the lack of negative ones, said he agrees, after that, plus my thorough explanation, albeit in somewhat simplistic terms that I could speak to a GP and have him brought to understand, or to a degree comprehend, the unusual highly selective, partially voltage-gated/depolarization sensitive rapid on-off binding and dissociation from overactive NMDARs whilst sparing normal, healthy NMDAr-mediated glutamatergic traffick and longterm potentiation, a key component of encoding memory engrams, the affinity it also has as an alpha7-type selective nicotinic acetylcholine receptor antagonist, which in the very short term, due to agonists here being nootropic memory and cognitive enhancers, it has a brief dulling phase, as the antagonism blocks Alpha7 NAChR signalling, but at the same time, due to this, there undergoes a counteracting homeostatic response that induces upregulation of alpha7 NAChR expression and increased sensitization of the receptor, essentially a reverse-tolerance that is put to useful effect, leading to an unusual biphasic onset of effects, a brief mental dulling that is essentially an induction phase to be expected and waited out for a little while before the compensatory mechanisms kick in and lead to a net increase in alpha7 neuronal nicotinic acetylcholine receptor activity leading to non-glutamatergic side effects of nootropic effect, as cognitive enhancer and memory-strengthening agent.
But he's been saying so for ages, blithering on about some shit about approval from some other body, who he's had to appeal to, and all kinds of crap. I'm getting to the point where it is starting to feel like empty words and hollow promises that will never bear fruit, and that I'll resort either to the internet, or, if I can find suitable supplies, to construct the methylated adamantanamine structure myself with my own hands, that I know I can trust to do what I expect of them, and require no bollockspeak to some invisible medical authority.
I KNOW it works, on so many different levels, all of them positive bar the initial alpha7 NAChR antagonism, leading to short term and temporary cognitive dulling, that soon bounces back to above-normal levels, bringing with it the inverse, a memory enhancement. It is, in every respect, a smart-drug. A work of art, in terms of it's elegant molecular pharmacology, subtle, yet immensely powerful when correctly deployed.
One way or the other, I'm not going to sit on my arse much longer and listen to empty words and hollow agreement with me, that leads to nothing but an echo of my own voice coming from the GP in question. He's a decent guy, but he's no neuropharmacologist, and admitted to me that I had to dumb things down a lot before he'd be able to follow what I was putting together for him, and more or less that in general, I tend to run mental rings around him, unintentionally, when trying to talk to him as an equal. I find that rather saddening, for him, really, but there isn't much I can do, not as if I can continually mentor and train him myself, but at least it does give me a firm footing to accept or reject what otherwise may have been forced on me from on high, so to speak, despite it's not being the right decision for my best functioning, medically speaking; in the sense that if he tries such, and gives an explanation, which of course, I do insist upon, rejecting any medical change born from the personal whims and prejudices or in-built learned patterns of behaviour from a GP, instead, requiring, firmly but politely, that my treatment be guided by evidence-based medicinal practice, to the greater good, playing the side effects of one medication against those of another for example, and nullifying bad side effects, or amplfying positive ones, playing off feedback loops and homeostatic adjustments where possible to good effect, or to negate nasty side effects or at least knock them down a peg or two.
I just wish my GP was capable of doing the same without needing to be guided as if teaching a kid how to stick lego blocks together. Because as I would have it, I'd turn the basic medical protocols in place for me into a self-harmonizing work of art, not using one sticking plaster to stop another falling off too quickly.
I can do it, in a good number of ways, but it takes so much time, if I have to take to the net to get certain nootropic agents, or spend the time carefully reacting this, that and the other, purifying and recrystallizing each and every batch until it is up to scratch, analytically speaking and fit for my requirements. And a truly adaptive, personalized polypharmacy tailored to catering to multiple needs and desires without causing ill effect, requires not only a careful planning, but an elegant execution, turning the whole into a greater thing than the sum of it's individual parts. Meaning many gentle nudges here and there in just that slight alteration of course, or occasionally greater central alterations made, its easy to say, but difficult to do, and requires IMO, a personal knowledge of one's own body chemistry and wetware-wiring if one is to hack it to good effect rather than ill.
So it's time and effort, and even I cannot be constantly running many different syntheses with multiple steps and cleaning procedures, analysis of purity, recleansing if needs be, re-assay, before being deemed fit for consumption, and if I could, what would that leave me in terms of both time to act upon other scientific endeavors for, often as not, non-medical science, done purely for the sake of gathering knowledge and feeding on it, and what money would be left to me after spending a lot of cash on bulk purchases to whip up big batches of whatever arrangements are to be used in an idealized situation, to buy myself items such as replacements for any damaged glassware, new items of glassware that I covet as of yet, and above all, just the opportunity to head on off to the lab, my private little sanctum sanctorum, and home within a home within which no other may tread, not even family without my explicit say so, where I can go if stressed for example, and just work that stress away and redirect negativity into creativity.
Today-8 quid or so in cab fare to the GP surgery to pick up scripts, 130-140 quid in groceries, including a few little treats for me like two tubs of my favourite honeycomb and clotted cream honeyed ice cream, couple of packs of cigars, the entire stock of a knockoff red bull identikit mimic that were being discounted at just 25p a can, nabbed the lot of those, a 30pack of canned coke, diet, unfortunately, but such is life, one cannot have one's cake and eat it as they say. I prefer real coke to diet or that zero shite, proper sugar not sweetener tainted, but hey, a 30 can crate of diet for a few quid, vastly cheaper on a per liter basis than buying it in plastic larger bottles, it was there to be bought, so I did. And a 6 pack of bottled bud, plus, just for a personal treat because I had gone without any tantalising delicacies by way of daily fare for too long, a 4 pack of the expensive, but delicious italian peroni lager, that you can just bet will be all gone before any of the budweiser gets cracked open. In fact, I think I'm going to grab another out of the fridge now.
Not to get pissed or anything like that, something I find rather difficult to purposefully cause, using beer alone, due to the volume of fluid compared to ethanol concentration, but just because after two weeks of eating porridge for breakfast, porridge for elevenses, porridge for dinner, porridge for tea and porridge for supper too....well, lets just say that as much as I enjoy oat porridge made with a good dash of salt and some brown sugar stirred in with a big hunk of melted butter while it's cooking, and then a lashing of dark, flavoursome molten molasses as a topping, there is only so much room in the average, or even the non-average spazz with at least latent to a degree sameness-freakoid tendencies lurking's psyche for the sight of ANOTHER pan of...you know what my next meal would have been, I can guess?
So, a bit of a splash out on expensive beer, candies in variety and profusion according to what is available to suit my tastes, why not, eh? why the Hades not? if I've gone and lived a dietary life possibly more suited to an ascetic or monastic type for a couple of weeks due to no money spare, when getting paid twice over in two days, as this week I get my disability money for the joint problems, and the day after, a large chunk of cash paid every other fortnight for me to carry on busily being autistic, apparently. Arranged for me as a kid by the folks, and never questioned, it just keeps coming in, and AFAIK will do until Gotterdammerung, just to pursuade me that I'm meant to keep being a speshul spazz and not slip and fall into the gross, less refined and all too often ape-like ways of the NT hordes.
Am I being a tad of an arrogant autistic bastard there....? just maybe, but at least I'm not afraid to own it
And even less so to get paid to own it *flaps amusedly* A sort of autism tax on the government, to offset the stupidity inherent in politicians and their lickspittles and arse-toadying fawning clades of personal sycophants and ego-masturbators, in order to overall, at least contribute to the balancing out of such negative creatures impact on society with their empty heads, with good logical minds...
I could live with that haha.
