General Release Form: Fill & Download for Free

As Amy says, generally only the very fit survived. But also, long-term malnutrition, if it doesn’t outright kill you, slows the metabolism. Prisoners released form the gulag often looked younger than their chronological age.

A few milliseconds.The question is poorly formed, because it doesn’t seem to understand that dopamine is released as a neurotransmitter, and neurotransmitters are normally destroyed moments after being released. There’s this pop-psych notion that pleasurable things fill your brain with dopamine like your brain is some kind of squidgy tank, and then that dopamine has to go away. That’s not how this works. That’s not how any of this works.Your dopaminergic neurons in the reward centers of your brain will continue to produce dopamine as long as they’re active and transmitting to one another, and that dopamine will go away within a few milliseconds to a few hundred milliseconds after they stop. In addition, dopamine and prolactin are generally released in inverse relationship with one another; when you’re engaged in sex, for instance, you will show an increase in dopamine production, and then after orgasm prolactin will spike and dopamine will drop. (Prolactin is part of the system that mediates the refractory period.)This is different, of course, if you’re using drugs that inhibit dopamine reuptake. But generally speaking, the notion that your brain “fills up” with dopamine when you engage in pleasurable activities is not correct.

Yes. Blatantly. And I called him out on it. Allow me to explain:I was referred to a neurologist for my Migraines. Now, having dealt with this disease for many many years, I was already very familiar with available treatments and also was very familiar with what treatments I have not tried yet. I had done my research and was very familiar with the few options that had not been explored, and knew how they worked, how they were administered, and was familiar with the side effects and potential contraindications.Ok, so I attend an appointment with this new neurologist who clearly had not familiarized himself with my health care records or even my migraine history. He hadn’t even bothered to review my list of health conditions, current medications or my allergies before he came in to see me. After the usual basic examination and discussion of past failed treatments and such, he recommended Botox. I explained (again, something that was on my intake forms for this clinic specifically) some of my family history, and further explained why I was not a candidate for this treatment. But, since I was there, I asked him about it - just out of curiosity as to what he would say. I had already begun to doubt this doctor’s integrity at this point, and wanted to see just how deceitful he truly was.So he begins telling me about how it’s administered and where the injections are generally placed. He indicates the approximate number of injections in the average patient… and then I asked about side effects. His response? “Oh, there aren’t any.” So I’m sitting there and I’m just looking at him. Actually, it was more like I was staring at him - I’m pretty sure my jaw even dropped open. And so again, I reiterated that I was interested in the side effects of Botox. And he repeated the same thing - ‘there aren’t any’!!Now, any migraine patient who has been down this road will have done their research before seeing a new doctor or even before seeking information from a medical professional about a new treatment option. And that’s not to mention that Botox had become a very heavily advertised treatment at that time, so the website was very easily accessed and very informative.So - I point blank asked the doctor - “So you mean there isn’t a single side effect? Isn’t this a strain of the botulinum toxin? The same that is used to treat wrinkles in cosmetic medicine?” And he agreed that yes, this was the same substance, and that it had been discovered that it was helpful for some patients with Chronic Migraine that occurred at least 15 times a month or more. I then asked what the odds were that it would be effective. And he stated that it helped nearly 90% of patients who tried it. And he even went so far as to say that patients who tried it reported that they experienced almost no attacks and that even those attacks they did experience were significantly reduced and easily managed.Now to hear him talk about it, you’d think this was a miracle cure and that everyone would be clamoring for it. What he failed to discuss is the fact that Botox injections can affect ones breathing and airways. It was contraindicated for those who suffered compromised breathing, such as COPD or asthma patients. It can cause drooping eyelids. It can cause paralysis of the facial and upper body muscles but that it usually resolves on its own - but not always. Had he bothered to mention even one of those things, I might have been more restrained. However, he failed to mention any of them!Now - keep in mind, I was a very well prepared patient - exceptionally familiar with the treatments I had not yet tried. After he blatantly and straight-face told me these outright lies, I calmly asked him if he had ever read the pamphlet that comes with the medication. I asked him if he’d bothered to learn about the treatment - aside from how to administer it - or if he had even spoken to the drug reps who had so kindly left their advertising pens and such. Before he could answer, I then - again calmly - proceeded to list every single side effect and contraindication for the medication. I then reviewed my family history and my health history specifically identifying the conditions that prevented me from being a candidate for this treatment option. Then I also corrected his statistics on efficacy. Botox has a 50/50 chance of being effective in most patients. Those who do experience a positive response generally experienced a reduction of attacks anywhere from three to five episodes less per month on average, and some could also experience somewhat less intensity of their attacks with or without the reduction in number of attacks.He attempted to argue the issue and so I simply stated “well, I’ll discuss it with my husband before I make a decision” knowing full well that there was no way in hell I was going to submit myself to this treatment option. After that, I asked him about three other medications that I had heard may be effective. He condescendingly said “Well, I guess I could prescribe (x) for the meantime until we can get you scheduled for those injections.”… I was appalled to say the very least, but held my tongue.So then he leaves the room, and after a minute or two, returns with two sample bottles of said medication in extended release form. Before he handed me the bottles, he removed the patient handout pamphlets and discarded them! Then he proceeds to tell me how he is prescribing it - being familiar with the medication, I was fully aware that the starting dose he was prescribing was three times as high as it should have been and his taper-up dosing was almost a guarantee that I would experience the typical side effects in extremely obvious and intense levels. He then tells me that he’s giving me the extended release forms, but he’s prescribing the immediate release form since the VA would not carry the one he was giving me in samples. ???? Why would you provide samples of a medication in a particular form to start therapy and then prescribe an alternate form knowing your patient would not be able to access the one they started on???Just to validate my concerns with the prescription, I hand carried it to the VA pharmacy and showed them the sample bottles he had provided. They looked at the prescription and then the bottles. And then again, the prescription and then the bottles. And then the pharmacist asked specifically what the doctor had said to me. When I repeated what he’d said, the pharmacist told me that the directions and format of the drug was way off. He advised me to discard the samples - especially since they’d been dispensed without the patient pamphlet - and he rewrote the directions for taking the medication.Even despite the prescription, there was no chance - zero chance - that I was going to return to that charlatan. However, I was concerned that other Veterans would be referred to him, and even that other patients would see him from the public sector. So I promptly reported my experience to our scheduling office as well as to TriWest who was at the time managing the Veterans Choice Program. Then I reported him to the medical licensing board in the state of Kansas. I don’t know what actions were taken, if any, but I did what I could to possibly save the next patient from the horror that I experienced. I also sought out some of the websites that allowed patients to report on experiences with doctors in the local area. And I posted my experience as well as my warnings to avoid this provider, but if they were going to see him, to be certain to do their homework and research prior to their appointment.So yes. I have been not just lied to, but blatantly and obviously lied to, by someone who had a medical degree and was actively treating patients.