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Did even read the link you supplied ? Or were you drawn in by the 'Doctors are the Third leading Cause of Death' tabloid headline and then failed to check out the sources, look in to the credibility of the author or even read the article itself ?
um, approximately that would be, yes, sort of, yes, yes and pfft, course i read it...
Again, did you read any of this, did you even bother to read the abstract ? Or were you drawn in by the '[I why most published research findings are false'[/I] tabloid headline and then failed to check out the essay itself ?
please see above (minus the pfft bit).
How do you think this essay is relevant to the idea that we are overmedicated ?
it isnt actually, but let me explain... in a sec.
Firstly, the headline is quite funny, a little misleading, no one is inventing diseases....
true. i worked this out. you worked this out, i hope that most people correct that kind of thing in their head.
so yea i kind of posted this lot inb a funny mood after i'd been reading a bunch of different things from different threads and forums and other places. what was striking me at the time and actually what my original rant (which i deleted) was about was my frustration that as a layperson it seems incredibly difficult to know what is correct in certain fields of interest or study. i was following links and came up with those three and posted them more as an illustration of my frustration than anything else. though there was a semblance of relevance in there. we've done comfirmation bias before and i failed miserably in your test. which, strangely is where my post came from. i was trying to disprove my opinions on a dietry choice as being more healthy than another. and what i ended up with was confusinon and frustration at not seeming to get a clear answer. it is possible to check every source and every study to find the methods and etc etc but like i said as a lay person with no experience or real understanding (and yes a short fuse for trawling) dam i was none the wiser. for me the links just kind of summed up my irritation, perhaps in a different way to how they irritated you. why i asked again if we are overmedicated? for me it was less about the actual use of medication (in the first article) simply the link between numbers of (apparently unnecessary) deaths and where they occur - in the medical facility. loads of people die in hospitals and on the table of an O.R every year. and of course you dont know if a person would have died if they hadnt recieved the drug that caused the fatal reaction etc. but for me it was easy to link the overmedicated word into that set of numbers in a very loose sense. the interventiion of the medical community and the deaths caused by it = overmedication or thereabouts.
the one about false research findings, i admit i stopped reading fairly quickly. i dint understand it. and no i didnt post it to be relevant to the overmedicated talk. more to highlight my annoyance at not finding simple answers. and when you find answers there are always conflicts and counter arguments and then can you (i) even believe the answers? no. apparently not. and therein lies my frustration. unless you are only using google to do mm to inch or £ to $ conversions it seems like you have to do endless trawling to find answers. and then you find opposing ones. and you (i) just go, "fuck it. i cant be fucked woith the amount of shit on the internet, why do people who are paid to do research end up with different answers? why cant people just publish true accurate findings?" - rhetorical question.
the last one about inventing diseases; like i sadi, i know they arent inventing, and i agree with what you wrote. the article was poor in my mind. maybe in this one we are being over media'd. as in is the media inventing stories to sell more papers?
anyway, it kind of reminded me of a chris rock sketch about medicval commercials. i've tried to find it but cant so it wont be so funny.. anyway, commercials listing listing syptom after symptom until you realise you have one symptom and need to get that drug.
"i heard one informercial the other day that said; 'do you go to sleep at night, and wake up in the morning'"
i listen to internet radio and some of the commercials on there are crazy, trying to get people to take drugs to lose weight telling people not to change their diet or lifestyle just take the drugs. "it speeds up your metabolism so you lose weight with no effort". personally i'd say tis was overmedicating. i mean, you can lose weight without drugs, and without the possibility of side effects of said drugs. and what about when the free trial runs out? you have to buy the drugs because they hooked you on the losing weight the lazy way.
my saying that im not discussing it was meant as in im not discussing the definition of overmedicated. theough clearly i have a little bit. loosley, my dea of overmedicated is something like this..... when medicines are used or the medical community are involved in a drug/surgical proceedural way (possibly a made up word there), when there is alternatives that are more 'natural' and arguably safer with less sideffects..... my idea of overmedicated would also include something along the lines of...... when the accidental death o f a person is caused misrtakenly by a mistake/adverse reaction to drug etc etc when in the care of the medical community...... examples such as the above, of drugs that make you lose weight by speeding your metabolism (which would, i imagine have knock on effects in the complex systems of the body). instead of perhaps just changing diet and lifestyle to lose weight?? or he example in the article giving numbers of people dying through adverse drug reactions, or while under anaesthetic etc etc.
im not trying to build a foolproof case here. or even a non fool proof case. i would hazard a guess that there are plenty of occasions when drugs and surgery aren't required, but given anyway. but i have no evidence to support what i said. it doesnt mean there isnt any, more that im not so bothered in trying to find it.
I am sure there is a decent argument to be made for the idea that we are overmedicated,
yes i agree. the difference is that you appear to be more concerned about it than i do. you want things to be supported and proven, and im just happy to have idle beliefs on subjects that dont feel of particular consequense to me (despite my ramblings above).
but these links look to have been dug up for their scandalous headlines
you are right here too, but i hope i have explained myself a bit better.
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death o f a person is caused misrtakenly by a mistake
looooooser.
dam im tired. i cant believe how bad my spelling, sentence construction and grammar is when im tired. sorry to anyone who endureds the pain of reading it....
goodnight.
zzzzzzzzzzzzzz
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yeah so you can demand a brand from the GP - sounds messed up.
Sounds fucken ace to me. I'm on a branded, patented, variant of a drug I found out about thanks, one imagines, to their marketing of it to consumers, since I first heard of it on a user forum. If they hadn't drawn users attention to it directly, I certainly would never have been put on it by my doctor, since NHS prescribing is done on generics by default. It's a small but important variation, just a different preparation of the same active ingredient, but it allows me to get the same therapeutic benefit with a lower dose and hence reduced side effects. The extra cost to the NHS is of the order of tens of pounds per year, up to maybe a couple of hundred for users on the highest dosing regime, so they have no incentive to draw patients attention to it, especially as hardly anybody has side effects which impose further costs on the NHS
We have pretty tight regulation of the claims which manufacturers can include in their marketing, and however much a punter might still be misled by claims they can still be refused the product by their doctor if the doctor knows its wrong for them, so I can't see any harm in letting patients have access to information, which in practice means letting PharmCos advertise directly to the public. There will be some patients who waste doctors' time asking for stuff which is inappropriate, but there will likely be just as many who receive improved care as a result of going into the surgery with ideas which time-constrained doctors might otherwise have overlooked.
Oh, and my other drug I insist on being prescribed the branded product because it tastes nicer than the generic. It's that kind of selfishness which puts the NHS drugs budget through the roof :-)
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I hate these spoof periodic tables which are not faithful to the genuine symbols, it's just lazy.
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true. i worked this out. you worked this out, i hope that most people correct that kind of thing in their head.
Agreed, most people work this kind of thing out quite readily, but even when we do understand what is behind the title we can still have our views coloured by something as apparently unimportant and easily dismissed as a sensational headline without knowing we have had our views coloured - and I am not talking about those people whose credulity lets them be swayed by a headline. We all weight information more strongly when it appears early in a process, we show a preference for early information, we suffer what is known as an irrational primacy effect which is what these kinds of sensational headlines tap into, the thing is you will not be aware that you have been effected by it or that it had coloured your further progression through the rest of the information.
Going off on a bit of a tangent here so I will stop.
i was trying to disprove my opinions on a dietry choice as being more healthy than another. and what i ended up with was confusinon and frustration at not seeming to get a clear answer. it is possible to check every source and every study to find the methods and etc etc but like i said as a lay person with no experience or real understanding (and yes a short fuse for trawling) dam i was none the wiser.
I can't imagine trying to find out the better option out of two dietary choices would be that difficult, using the right tools you should be able to get a decent idea pretty easily and fairly quickly ?
for me the links just kind of summed up my irritation, perhaps in a different way to how they irritated you.
Well to be honest it was the first one that set me off, looking into the author, the website in general and the preposterous nature of the article itself left me wondering how anyone could read something like that and take it as anything other than a stupid agenda driven article born out of pre-existing ideas.
why i asked again if we are overmedicated? for me it was less about the actual use of medication (in the first article) simply the link between numbers of (apparently unnecessary) deaths and where they occur - in the medical facility. loads of people die in hospitals and on the table of an O.R every year. and of course you dont know if a person would have died if they hadnt recieved the drug that caused the fatal reaction etc. but for me it was easy to link the overmedicated word into that set of numbers in a very loose sense. the interventiion of the medical community and the deaths caused by it = overmedication or thereabouts.
Again, I would hope to squeeze out of you a better or clearer idea of what you mean by overmedication, if you are using it to mean - in this context - any number of deaths in a medical facility that are not directly attributable to the condition the person was being treated for, I would still struggle to label that overmedication as all medication carries a risk, that someone dies from a poor reaction does not mean that they were overmedicated.
I could kill my big brother with a brazil nut (and many other people with nut allergies), but similarly he could not be said to have died from overeating.
Also the idea that these deaths are unnecessary might not be as clear cut as that, I could argue (and this is only to make the point) that when taken on the level of the medical facility and not the individual they are entirely necessary, any medical intervention carries a risk, that risk, however small, is averaged out across all the patients who fit into our category (those needing medical intervention that carries a risk) - as is the success of the medical intervention, we cannot have perfect cross-patient medical intervention as the nature of the situation inherently carries some risk, we cannot (at present) separate the success from the risk, they are part of the same process, so to remove risk is to remove medical intervention, we can scale back the risk or even negate that risk entirely by scaling back medical interventions or stopping them entirely.
But of course we wouldn't want to do that as medical intervention does vastly more good than harm, so to intervene we must necessarily expose people to the risk, we must necessarily place people at the risk of dieing from the interventions (and of course, some do) . Probably a good analogy would be a vaccine, like all medical intervention it carries a risk, so although we shouldn't be indifferent to the deaths of a few people from a poor reaction to a certain vaccine (and we should always strive to minimise this through improvement of the vaccine's safety profile) we just have to remember that without the vaccine there would be vastly more deaths.
the one about false research findings, i admit i stopped reading fairly quickly. i dint understand it. and no i didnt post it to be relevant to the overmedicated talk. more to highlight my annoyance at not finding simple answers. and when you find answers there are always conflicts and counter arguments and then can you (i) even believe the answers? no. apparently not. and therein lies my frustration. unless you are only using google to do mm to inch or £ to $ conversions it seems like you have to do endless trawling to find answers. and then you find opposing ones. and you (i) just go, "fuck it. i cant be fucked woith the amount of shit on the internet, why do people who are paid to do research end up with different answers? why cant people just publish true accurate findings?" - rhetorical question.
Differing outcomes suggests the researchers are not themselves agreed on the issue yet, they have not yet found broad acceptance. I wouldn't wait around for complete agreement on anything, a general consensus is about the best you will get in science.
""fuck it. i cant be fucked woith the amount of shit on the internet"
This comes back to my instance on asking for a clear and detailed explanation of the hypothesis (we are overmedicated) - if we are putting the idea forward we should be able to test the idea, we should be able to falsify it or confirm it.
I think you would find it less frustrating on your Google safari if you knew what you were looking for, rather than the vague catch-all of 'overmedicated'. If you were looking for falling renal functionality (mapped across several decades) through drug burden as an indicator of overmedication - - then you could read the studies and literally come away with a 'yes' or 'no' answer to the questions are we 'overmedicated' (if you judge falling renal functionality to be a good indicator of overmedication) - without a structure, without a clear definition of what it is you are trying to establish you are just going to end up being exposed to opinion.
Without that definition 'overmedicated' becomes pretty much anything you want it to be, my gran having her medicines doubled is overmedication, my gran having her medicines halved is proof of overmedication, a man having a bad reaction to an anaesthetic in the dentists chair is overmedication, menopausal women being offered remedies is overmedication . . . and so on.
i listen to internet radio and some of the commercials on there are crazy, trying to get people to take drugs to lose weight telling people not to change their diet or lifestyle just take the drugs.
Are you sure, they actually say not to change your diet or your lifestyle and just take the drugs ?
Can you remember the name of the drug, the name of the company selling the drug, the manufacturer or anything like that ?
loosley, my idea of overmedicated is something like this..... when medicines are used or the medical community are involved in a drug/surgical proceedural way (possibly a made up word there), when there is alternatives that are more 'natural' and arguably safer with less sideffects.....
Can you give an example of an 'alternative' that is has a better safety profile, less side effects (and I am assuming comparable efficacy) to a commonly used drug - so I know the kind of thing you are talking about.
How are you using the word 'natural' in this context, and in what way is something being more 'natural' better ?
By this definition (overmedicated = using a drug when there are 'more natural' alternatives available). . . .
A -- if a tiny amount of an anticoagulant is given to a patient, say once every 10 years, this counts as overmedication ?
B -- if there is no 'natural' option for a particular drug it is still overmedication ?If B is true then any drug use is overmedication, if B is false then we can inject large amounts of required drugs into a patient and it would not be overmedicating, while A would still be overmedicating.
?
my idea of overmedicated would also include something along the lines of...... when the accidental death o f a person is caused misrtakenly by a mistake/adverse reaction to drug etc etc when in the care of the medical community......
Excuse the ridiculous hypothetical example but . . . .
A 32 year old man is brought into A&E, he has been in a road traffic accident, he has never in his life so much as taken an aspirin, but when he is given something to ease the pain he reacts badly and dies - would you say that he has been overmedicated - let's say he was given half a paracetamol ?
If this is a definition of overmedicated you recognise then there are plenty of examples of overmedication out there - and if I were to agree (seeing as some people do react badly to certain medicines) that we are overmedicated using this definition (essentially: adverse reactions = overmedication) then I would also have to return to my big brother's nuts (oooOOhhHHH!) and say that those who have died from a nut allergy were overeating.
yes i agree. the difference is that you appear to be more concerned about it than i do. you want things to be supported and proven, and im just happy to have idle beliefs on subjects that dont feel of particular consequense to me (despite my ramblings above).
Fair enough.
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Sounds fucken ace to me. I'm on a branded, patented, variant of a drug I found out about thanks, one imagines, to their marketing of it to consumers, since I first heard of it on a user forum. If they hadn't drawn users attention to it directly, I certainly would never have been put on it by my doctor, since NHS prescribing is done on generics by default. It's a small but important variation, just a different preparation of the same active ingredient, but it allows me to get the same therapeutic benefit with a lower dose and hence reduced side effects. The extra cost to the NHS is of the order of tens of pounds per year, up to maybe a couple of hundred for users on the highest dosing regime, so they have no incentive to draw patients attention to it, especially as hardly anybody has side effects which impose further costs on the NHS
We have pretty tight regulation of the claims which manufacturers can include in their marketing, and however much a punter might still be misled by claims they can still be refused the product by their doctor if the doctor knows its wrong for them, so I can't see any harm in letting patients have access to information, which in practice means letting PharmCos advertise directly to the public. There will be some patients who waste doctors' time asking for stuff which is inappropriate, but there will likely be just as many who receive improved care as a result of going into the surgery with ideas which time-constrained doctors might otherwise have overlooked.
Oh, and my other drug I insist on being prescribed the branded product because it tastes nicer than the generic. It's that kind of selfishness which puts the NHS drugs budget through the roof :-)
Yeah thats ace and all, and I'm really glad you've found a good drug that works well for you, but as previously discussed on this thread quite a lot of what a drug does is down to you, as blind tests with placebos show.
This sounds patronising, sorry, but you can see my point, that if you prescribed the own brand drug in the branded box, it might do the same thing? (thats a big might by the way)
I would say it would be interesting to test it out, but its your life innit. Do you ever wonder when taking the drug if (for example it was aspirin) its effect seemed lessened in someway that you might get super paranoid and wonder if the more expensive drugs had been substituted for cheaper ones? -
This sounds patronising, sorry, but you can see my point
Yes, I can see that you think I'm some dumb fuck who is taken in by snake oil salesmen. The drug preparation I'm talking about has been proven effective at lower doses than the generic in proper trials, not just the usual double blind controlled trials using spirometry (it's an asthma drug) to objectively measure effectiveness, rather than just patients' subjective reports, but also backed up with chemical analysis demonstrating that the active molecule ends up where it should be more with the patented preparation than with the generic. I read the user group recommendation, then the manufacturer's marketing, and then the trial reports, before asking my doctor to switch me to the new version. Even after all that, I'd have been open to hearing his critique of my request if he'd had one, but he agreed completely that is was a better option, and clearly nearly everybody would be on it if we had private rather than public medicine, since any sensible person would pay the small extra charge. That's a different debate, though.
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dang, dont you ever sleep?
we suffer what is known as an irrational primacy effect
woooo yes we (i) do.
I can't imagine trying to find out the better option out of two dietary choices would be that difficult, using the right tools you should be able to get a decent idea pretty easily and fairly quickly ?
well i was finding it pretty dam annoying. maybe im not so used to the right tools and methods to look.
Again, I would hope to squeeze out of you a better or clearer idea of what you mean by overmedication
this was the bit i didnt want to discuss. for me its like a catch all informal conversational thing not a scientific by numbers thing. in one scenerio it could mean one thig but another scenerio it could mean another. i really dont come at this from a scientific method perspective which mean you and i could go round in circles on this.
I could kill my big brother with a brazil nut
what are you a bond villain?
Also the idea that these deaths are unnecessary might not be as clear cut as that, I could argue (and this is only to make the point) that when taken on the level of the medical facility and not the individual they are entirely necessary
this is totally true. i was thinking more along the individual lines over the larger picture,on a totally subjective perhaps even anecdotal level...
But of course we wouldn't want to do that as medical intervention does vastly more good than harm. .... a good analogy would be a vaccine
yep. this i agree with.
a general consensus is about the best you will get in science.
and therein lies the base of my frustration as a layperson. if the best i can hope for is consensus (which appears to be unlikely) then we as the layfolk public are scuppered trying to find easy access to reliable info. which turns into my....
""fuck it. i cant be fucked woith the amount of shit on the internet"
I think you would find it less frustrating on your Google safari if you knew what you were looking for
actually i did know. it was pretty much this... "i have been led to believe that human beings are designed (lets not get started on this please - i think you know what i mean) for a diet of low fat, low protein, high carbohydrates from non animal sources" now it wasnt about what humans can live or survive on. more about diet for optimum health. diet to thrive on, ya dig? i've read articles championing both sides of the fence. then i read something more conclusive and wonder why the dam hell all the other stuff is there if this new bit is more accurate and better supported? so then i go down the route of investigating ketosis - a state induced by very low carb intake. from all ive read before, ketosis is a dangerous place to be, supporting the high carb low fat/protein side. but whats this? i come accross a site proclaiming the 'facts' about ketosis and how its totally safe (providing you arent diabetic) and in fact a very normal state for humans throughout a large portion of their history before they started relying on veg carbs. just look at the eskimo's yadda yadda. i got too pissed off to carry on. and as a vegan, part of me doesnt want to be given facts that a high animal protein, medium fat and low carb diet is the most natural and vitality giving diet for the human. but as a person who has suffered health problems for a large part of life i do want to know if i could be giving myself a better headstart in that one area. so im confused, the info is confusing, and all of that lead to this here discussion...
Without that definition 'overmedicated' becomes pretty much anything you want it to be, my gran having her medicines doubled is overmedication, my gran having her medicines halved is proof of overmedication, a man having a bad reaction to an anaesthetic in the dentists chair is overmedication, menopausal women being offered remedies is overmedication . . . and so on.
yes you are right.
Are you sure, they actually say not to change your diet or your lifestyle and just take the drugs ?
yep, scarey eh.
"in fact we encourage users not to change their diet or lifestyle in any way"
they "guarantee results". a "risk free trial" ( i can hear you asking, "please can you define risk free. exactly what risks are you guaranteeing this trial to be free from")?
Can you remember the name of the drug, the name of the company selling the drug, the manufacturer or anything like that ?
none of that info is given. its a 30 day free trial of a lisenced drug not available yet. tol free number is all. oh and its in the states. open itunes. click radio. click hiphop/rap and its clubradio's 90's hiphop staion. description says"all the 90's hiphop/rap channel" its only on after about 5 in the pm. 1700 for you army/national rail folk. listen for about 30 mins and you'll hear it. along with some great music*
*subjective
Can you give an example of an 'alternative' that is has a better safety profile, less side effects (and I am assuming comparable efficacy) to a commonly used drug - so I know the kind of thing you are talking about.
duh, homeopathy.
How are you using the word 'natural' in this context, and in what way is something being more 'natural' better ?
like, how much more natural, can water with 1 squillionth part of sunlight in get?
ok, more seriously. the context i was on about was weight loss, as per the commercial.
a more 'natural' and 'alternative' method or two would be to stop eating so much god dam rubbish food. and do some low impact excercise (to minimise injury rates of sedentary people - over sported? sport is killing people?). hows about that as an example? yes you take take a drug to lose weight. or you can be less lazy and put some effort in. ( i cant assume comparable efficacy, but my personal feling is that putting a little effort in and seeing the results of that effort are really really rewarding, and in the food/weight issue it gives you a more workable idea of how your diet and lifestyle actually affects your weight/happiness/sense of welbeing/health etc etc. so in this case, comparable efficacy is les important).
as an last ditch measure in life threatening circumstaces this drug may be a good idea, but i imagine there are a lot of people out there who would jump on this who arent in that state.
Excuse the ridiculous hypothetical example but . . . .
would you say that he has been overmedicated - let's say he was given half a paracetamol ?
no, not at all.
but in the equally ridiculous hypothetical example where someone goes to their GP and says......
"im realy worried about my weight. its too much, but im a little concerned as how to go about losing some, could you refer me to a nutritionalist or give me some guidance to gentle excercise to help kick start the revolution of my life so i can change and become healtier and happier? please doc?"
and the GP says
"nah forget about putting in effort, what you need is this new drug. you dont have to change anything in your lifestyle or eating habits. you just take this drug and you'll lose weight. much easier. and if you dont like swallowing pills then crushit up and put in your ice cream. easy"
i would argue that this could fall into the broad, as yet un-defined spectrum of being overmedicated in two ways. 1)the physical use of the drug. 2)the unquantifiable effect on the thought processes of the big guy from the poor attitude of the GP. the efect of the exposure to the medical proffesion, in this example, the GP being the face of it.
it seems like you want to eliminate the glut of trash talk and unsupported ideas from the world/forum overall. and thats good and not trying to stop that.
other people are only concerned in certain areas. like me trying to find info on diet up there ^^^^ and wanting clear supported answers. and on other subjects, simply being happy to have ideas bandying around and anecdotes and all that informal stuff. a shocking and readily admitted double standard on my part.
its interesting for me to notice that i've had personal experience of at least 7 of the things on your spoof periodic table. good experienes which i felt helped me at the time. this whole thread would have had a different affect on me back then, but now i can laugh it off and go ha, placebo, yea probably was just that. this is just an unrelated sidenote.
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I didn't read N3lsons as a misunderstanding of the placebo effect. Earlier in the page we've been talking about branded versus generic versions of the same drug (Nurofen vs generic ibuprofen).
I also misread MDCC_testers's post as being of a similar issuec (i.e branded verson of the same thing).
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Yes, I can see that you think I'm some dumb fuck who is taken in by snake oil salesmen. The drug preparation I'm talking about has been proven effective at lower doses than the generic in proper trials, not just the usual double blind controlled trials using spirometry (it's an asthma drug) to objectively measure effectiveness, rather than just patients' subjective reports, but also backed up with chemical analysis demonstrating that the active molecule ends up where it should be more with the patented preparation than with the generic. I read the user group recommendation, then the manufacturer's marketing, and then the trial reports, before asking my doctor to switch me to the new version. Even after all that, I'd have been open to hearing his critique of my request if he'd had one, but he agreed completely that is was a better option, and clearly nearly everybody would be on it if we had private rather than public medicine, since any sensible person would pay the small extra charge. That's a different debate, though.
Easy tiger...i'm not trying to offend you...might have read your post quite early int hte morning and only paid attention to the bit about reduced side effects, and i was hypothesising, not suggesting you were stupid.
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Yeah thats ace and all, and I'm really glad you've found a good drug that works well for you, but as previously discussed on this thread quite a lot of what a drug does is down to you, as blind tests with placebos show.
No, no, no, no !
You have misunderstood the placebo effect, the placebo effect will not address an underlying physiological issue, it has no actual therapeutic value in treating a physical disease, It also cannot produce any kind of measurable improvement. Its value is in the reduction of symptoms that can be self-reported by the patient.
Basically, it can help the way a patient feels, but it can't treat their illness. So if you are suffering from a condition where their is no actual disease or physical or physiological problems like stress or insomnia, it can help you feel better, but where there is a actual disease agent or an actual physical or physiological problem it literally can't do anything - it's only with those conditions that our bodies can address themselves where it can be useful (and even here it only works on about a third of patients).
If you give a insomniac a sedative and to another a placebo, they both might get a good night's sleep.
If you give a haemophiliac a drug and to another a placebo, the one with the placebo will likely bleed to death. Regardless of what he thinks the drug might do.
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i'm getting some deep tissue this week.