#I'm not even going to touch the menstrual cycle bullshit

[grison-in-space]

*rubs forehead* Y'all. This shit is nonsense.

The linked handout appears to come from Dr. William Dodson, who is an ADHD specialist but has no apparent special expertise in pharmacokinetics or medical interactions, and he does not cite a source or lay out reasoning for the statement. The handout appears to be focused on two specific agents: ascorbic acid, AKA vitamin C, and citric acid, so I went looking to see if I could find the basis for these recommendations.

I suspected that the well-known actions of specifically grapefruit juice might be interacting with the likelihood of these recommendations, so I checked there first. As it happens, grapefruit is not recommended for many psychatric medications for reasons that have absolutely nothing to do with its vitamin C or citric acid content: grapefruit specifically contains compounds called furanocoumarins that block a particular type of enzyme that is extremely important in breaking down drugs and toxins. Too many furanocoumarins, and you don't metabolize those drugs correctly. ADHD stimulants aren't involved in that, though, so I circled back to look at citric acid and ascorbic acid specifically.

As far as I can tell, the focus on both types of acid stems from a game of telephone: amphetamine excretion is strongly dependent on urinary PH (Beckett and Rowland 1965), and there was concern in that "high doses" of vitamin C might acidify urine. This isn't an unreasonable concern, given that vitamin C (ascorbic acid) was widely prescribed as an urine acidifier at the time. This was a particular concern in the 1980s and 1990s when prescription of stimulants for ADHD was on the rise because diagnoses of ADHD were on the rise, because at the time there was a fad for consuming extremely high doses of vitamin C in exchange for poorly defined health benefits. Most famously, Nobel laureate and genuinely pioneering biochemist Linus Pauling had decided in the 1970s and 1980s that vitamin C was the solution to all known health problems, and as a consequence people were taking batshit high doses of vitamin C as a supplement.

It turns out that ascorbic acid is not very efficient as a urinary acidifier (Nahata et al 1977), because eating acid does not inherently make your pee more acid. For the record, the doses of vitamin C people are taking in these studies on urinary pH on top of whatever they get from their daily diet are around the 1-2 gram rate--or higher, as in this 1980 study that administered four grams of ascorbic acid per day without finding significant urinary pH changes. By contrast, a glass of orange juice contains about 0.124 g of ascorbic acid, which is fine: you only need about 0.09g per day, so that glass of juice will sort you out. You'd need to chug almost two liters of orange juice to approach those doses.

In case you were worrying, citric acid doesn't increase urinary acidity or do much to urinary PH either (Whitson et al 2007).

As of 2017, here's what we know (Markowitz and Patrick 2017):

After oral administration of AMP [amphetamine AKA adderall], most of the dose (>90%) is absorbed. AMP does not appear to be a substrate or inhibitor of the enteric efflux P-glycoprotein transporter (Zhu et al. 2006, 2008). Product labeling information for many AMP formulations reports that gastrointestinal acidifying agents (e.g., guanethidine, reserpine, ascorbic acid [vitamin C], and some fruit juices) may lower absorption of AMP, while gastrointestinal alkalinizing agents (e.g., sodium bicarbonate) may increase absorption. However, the influence of the coadministration of AMP with agents, which either decrease or increase gastrointestinal pH such as antacids and H2-receptor antagonists (e.g., famotidine), has not been thoroughly investigated. A study has assessed the influence of the proton pump inhibitor omeprazole, expected to increase gastrointestinal pH, on the pharmacokinetics of the d-AMP prodrug LDX [lisdexamfetamine] and MR-MAS [extended-release Adderall]. In this study, omeprazole had no significant influence on the extent of absorption of either formulation (Haffey et al. 2009).

I was trying to be thorough, so I checked all the articles citing that one in case something new has come out in the past decade or so. The most relevant is Childress et al 2019, which also could find no new examination of actual changes in absorption or excretion as a consequence of ascorbic acid or citric acid. They do, however, point out that lisdexamfetamine (Vyvanse) is not sensitive to urinary PH at all, so Vyvanse users have even less reason to worry.

I take my meds with whatever liquid is available when I need to take meds. You ought to do the same. ADHD is hard enough to deal with without inventing new rules about med intake to freak out about.

i know vitamin c basically neutralizes adhd meds but lemonade good

[scribeofwinchesters]

Secrets and Lies: Chapter 3 - Exposed

Pairing: Sam x Reader

Word Count: 2651

Summary:  While on a hunt with Sam, a witch reveals to him that you've been keeping a secret from him.

Previous chapters: One Two

A/N: Link to AO3 if you prefer to read there. Thanks for reading :) It means a lot to me when you take the time to like/reblog or leave a comment letting me know. I appreciate all of you <3

You'd been hunting this witch for half a week now. Her seventeen year-old daughter had 'broken her heart' by moving in with her boyfriend of two months and she'd gone on a rampage, turning mothers and their daughters against each other all over town. It was a subtle case, hard to track at first. The local police had chalked it up to 'synced menstrual cycles'. You politely explained to the sheriff's deputy the basic science of why that was categorically nonsensical but your temper got the better of you and before you knew it, you were raising your voice and Sam had to walk you out of the office with an apologetic smile and nod to the shocked, grey-bearded man.

You'd convinced Sam that maybe this case didn't have to end with a death. Charisse, you'd learned from her daughter, was just upset. Maybe she could be reasoned with. Maybe she'd come back to the good side. But then a body turned up and you'd had to console the girl who put a knife through her own mother's throat and couldn't even remember why and you were done. She was gonna pay.

You'd finally found her hideout: an old abandoned cabin several miles east of town, and there was a bit of a tussle but you had her back against a wall now. You and Sam stood a few feet back from her, guns raised.

“Oh, shoot...” Charisse said with a sarcastic frown and a playful tone. She giggled at her own pun. “I guess there's no point in trying to talk myself out of this is there?”

“You could try maybe acting sorry for what you did! At least for what you did to your own daughter!” you bellowed.

“That stupid, little bitch? I fed and clothed her for seventeen years! I gave her a house to live in and listened to her whiny bullshit and that was the thanks I got? She met that snobby little prick and that was it? She was just gonna leave me like I was nothing!” she cried.

“Don't act like you were some saint. We talked to Maggie. We know about the abuse,” Sam said, glaring intensely at her. Her eyes widened momentarily at the word abuse before she fixed her face back into a sneer.

“Is that what she told you? Lying infant...”

“Maggie is a sweet girl with a bright future. She's going to graduate on time and go to college. She's already been accepted to three different schools. You should just be grateful she turned out great despite your best attempts to ruin her,” Sam continued.

Charisse sighed heavily and rolled her eyes. “You know, if I'm about to die I think I'd really rather find a new subject,” she said as she glared at Sam. She glanced toward you for a moment. Her eyes narrowed as something about you caught her attention.

“Oooh, interesting,” she said as she looked down her nose directly at you. Sam took a few side-steps toward you, partially blocking you from her. You dropped your arms but held tight to the grip of your gun.

“Someone's got a secret,” she sang in a taunting manner, eyes still trained on you. Almost immediately your palms began to sweat. “It’s the only thing she never wants her dear, sweet Sammy to know.”   

No... she couldn't possibly... she was only a witch. She'd have to cast a spell to find out anything which she certainly hadn't done in your presence.  

Sam glanced back at you, his face unreadable.

“She's just trying to throw us off, Sam. She's a witch not a psychic,” you whispered to him.

She arched her brow and glanced sideways at the wall. She seemed to find the whole thing tiresome. “Could I not be both, dear?”

“She's... she's lying...,” you said as your breathing became shallow and your eyes widened.

“Oh! I touched a nerve it seems!” she said before setting her eyes on Sam who held his gun steady with one hand and reached his other behind him, guiding you to stay close as he side-stepped again to fully block you from her. You held your arm out and placed your palm high on his back, between his shoulder blades, in part to steady yourself as the panic set in, but also because you needed to feel him with you. You had to tell him now. He’d have to know. Sam was now going to know you had Castiel alter his memories to forget the night you almost died. Suddenly, losing him felt like a real possibility. If the current situation allowed for it, you'd probably wrap yourself around him and never let go. They'd have to pry you off him with the jaws of life.

You were staring distantly at the floor as your heart raced. Why did I do it? Why didn't I listen to Cas? Oh god, Sam's going to hate me. I changed his memories! I'm a terrible person!  You gripped tighter to his shirt, pulling it into your fist.

“Ask her and see what she says, go on, I'll give you a second,” she said, teasing. Sam hesitated, his eyes drifted from her as he thought for a moment but they quickly darted back. Her chin dropped and a smirk formed on her lips as she set her narrowed eyes on you. 

“It's the only thing she never wants you to know,” she sang.

Sam held his gun steady but glanced behind him to find you doubled over, holding tight to his shirt like it was your lifeline. Your eyes were wide and distant as you stared at the ground, your breaths shallow and rapid. It almost gave Sam a heart attack to see you like that. You were strong and happy and he’d never seen anyone or anything get to you like this. This wasn't like you at all. 

Charisse began giggling a horrendous laugh that made your skin prickle with goosebumps. You glanced up at her. She was fishing for something in the pocket of her dress. You looked back to Sam who was looking at you with almost as much worry as he had on that  night.

She was planning something and Sam was too busy worrying over you to notice and you were mid panic attack with uncooperative lungs. He hunched down before you, making himself eye level, and placed a hand on the side of your face, trying to make you look at him. You grabbed at his plaid shirt sleeve and once again balled your hand into a fist around the fabric.

“Look at me, y/n. Look at me. Take a deep breath,” Sam said, his voice thick with panic.

She finally found the hex bag she'd been searching for and held it up in the air as she began quietly muttering an incantation.

“Hex... bag...” you managed to gasp between breaths. Sam looked confused until you lifted your arm and pointed to Charisse. He spun around and your hand once again slipped from him. He pointed his gun at her.

“Stop! I will shoot you,” he shouted but she continued chanting, louder now that she didn't have to hide it. “I don't have time for this,” he yelled through gritted teeth. Two shots rang out and Charisse fell to the floor, blood dripping from her chest and forehead. He strode across the room, kicked the hex bag away from her lifeless body and stomped on it to ensure whatever she'd attempted to curse you with would never come to pass.

He tucked his gun into the back of his jeans and was immediately back at your side.

“Y/n, can you walk to the car? We have to get out of here,” Sam said gently. You nodded slowly. He wrapped his arm around your back and guided you out of the abandoned house. It was early evening and it was starkly quiet outside compared to the commotion you'd just left.

“It's okay. Deep breaths,” he said repeatedly as he guided you across the creaky porch and down the front steps.

“Don't leave me,” you squeaked out. There was a painful tightening in your chest at the thought.

“I'm right here, I'm not going anywhere, y/n,” Sam said as he opened the passenger door of the Impala.  

“Not yet,”  you thought. He held your hand as you sat down and planted your feet on the ground, facing him. He squatted in front of you and held your face in his hands. Your breathing was only slightly improved but your heart was still racing and you were still avoiding his eyes.

“Focus on your breathing, okay? Deep breaths. Let's try breathing in for five seconds and then out for five, okay?” You looked into his eyes and he smiled gently at you. “One…. two…. three…. four…. five….” he counted out loud. And then out, “One…. two…. three…. four…. five….” He grasped one of your wrists in his hand and it wasn't until much later that you’d realized he'd been taking your pulse.

It helped. With Sam’s counting and the calm, quiet surroundings, you managed to get your breathing back to normal.

After five rounds of the deep-breathing he was confident you could handle it on your own and stopped counting but kept his fingers around your wrist.

“It's okay,” he said softly. But without lives in the balance, he began to recall the witches words. He was slowly grasping the full situation. You didn't miss the way his eyes weren't properly connecting with yours. “It's okay,” he said again as he looked at the ground. You didn't believe it for a second.

A few more minutes passed in silence and your body returned to normal. You were calm now, other than that whole potentially-losing-everything-good-in-your-life thing, at least.

“Are you okay?” he asked.

You nodded.

“No, uh... are you okay, concerning... whatever it was she was talking about?” he asked, speaking slowly and gently.

You inhaled sharply.

“I, um... I don't know yet,” you said with a disheartened chuckle before finding the nerve to look him straight in the eyes. Sam looked away from you and nodded his head slowly as he sucked in his bottom lip. He gently shut his eyes for a moment and took a deep breath. He turned back to you, his face unreadable.

“Are you okay to go?” he asked. His eyes held yours for an extended moment before he glanced down.

“Yeah, I'm fine,” you said as you pulled your legs all the way into the car and faced forward. Sam stood up and walked to the other side of the car as you pulled your door shut.

When he was seated behind the steering wheel you placed your hand nonchalantly on the seat beside you. You'd done it a million times and a million times before Sam had reached across the seat to hold it in his. It was basically default mode when in the front seat together. But not this time. You left your hand there, unflinching, as you drove back into town. You felt exposed and with each passing second you felt more foolish and lost. You told yourself he was lost in thought and focused on driving. He looked it, too. His jaw was set and he looked at the road ahead as if he were charging an army. But finally, almost ten minutes later, you shifted in your seat and his concentration broke as he glanced to you. His face lit up like he was seeing you for the first time that day. His eyes crinkled in the corners as he gave you the tiniest smile. He then noticed your hand resting on the seat and immediately slipped his hand under it and pulled it up to meet him half-way as he planted a kiss to the back of it. He then turned his hand so it was over yours and pulled it the rest of the way to him, hugging it gently to his chest. Maybe, just... maybe, this wouldn't end in the fire and chaos you had imagined.

“Hey... Sam? Um... I'm sorry for leaving you hanging back there,” you said, speaking quietly and avoiding his gaze.

“No... no...,” he said with his brows low over his narrowed eyes. “No, you didn't. It's okay.”

“No... I- … I let my emotions get the better of me and that could've gone really bad,” you said. He placed your hand back on the seat but continued to hold it in his. You were back in town now, nearly to the motel.

“You couldn't help it. It's okay... she was trying to mess with us. She found a nerve and she picked at it. It happens to the best hunters. It's happened to Dean and it's happened to me. Promise me you won't feel bad about it,” he said, glancing earnestly in your direction.

A beat passed and you took a deep breath as you nodded slowly. “Yeah... okay.... I promise not to let that get to me,” you said, wondering if he caught your subtle emphasis of ' that '. You had plenty to feel guilty about otherwise.

“Will you start packing up our stuff while I check out?” he asked as he pulled into the nearest empty parking spot.

“Oh. We're not staying the night?” you asked, confused. It was just after seven and the bunker was a seven and a half-hour drive away. You had a motel room to yourself and no case coming up... It wasn't the kind of situation you tended to find Sam ditching.

“Well, I just figured... we finished the case. We might as well head home,” he explained lamely.

“We paid for the whole night. Aren't you tired?”

“No... No, I'm alright. I can get us there. Wouldn't you rather just get home and sleep in our bed? I know you hated this one,” he said, adding a knowing smile. This motel bed had been particularly crappy, leaving you with a terrible crick in your neck that even after an hour under Sam's massaging hands had done nothing to ease it.

You shrugged. “If you're sure.”

“Yeah, go on. I'll be there in a minute,” he said, cocking his head toward the door of the room.

It only took you fifteen minutes to pack all your bags and check the room for any clothing that might have been thrown somewhere accidentally... in haste. Sam was back from checking out just in time to help you load everything into the back seat. You both climbed in and began driving back to Kansas, your favorite music playing quietly through the speakers as the sun set behind you.

Edit: Chapter Four

[awed-frog]

hi! I saw your posts about the menstrual cup and I just have a question that nobody seems to answer in all the FAQs: how do you take it out? specifically, without spilling? I know you pull on the knob and voila but. it's a cup of blood. I'm imagining yanking it and suddenly blood goes splashing everywhere. is there a trick? am I overthinking? thank u sm

also – how do I know what size to get?? I know my shirt size but my vagina size WHAT. (I’ve never used a tampon either)

Hi, thanks for this question! I was wondering the same things when I first bought a cup, so here we go.

Extraction

Okay, so - technically, you can just make a pulling motion by grabbing the very tip and the cup will come out, but you don’t want to do that. I mean, it’s fine the first few times as you’re still learning, but if you take out your cup like you would a cork from a bottle, a) it will feel weird and b) you’ll get blood everywhere. So unless you’re a were-creature with very peculiar food preferences, maybe don’t.

What you need to understand is that the cup works by forming a seal against the walls of your vagina. That’s how the blood stays inside your body. So after you insert the cup, you should lightly pass your finger around the outside walls to check that the silicone is taut. Because you squish it and fold it a bit to get it in, remember, but then once it’s inside it should pop back into its original cup shape - check for that, especially in the beginning. And when you take it out, you perform the exact same movement: you grasp the base with your thumb and middle finger, and you exert a light pressure with your index so the cup will unseal itself from your vaginal walls. You want to create a fold, like this -

- only not that deep, otherwise the blood will spill. As I said, just a very small pressure with your index finger will ‘unpop’ the cup, and at that point you can move your thumb and middle finger to cradle it better so you can take it out by keeping it upright and don’t spill blood everywhere. 

It’s probably best to learn this in the shower, so you’re relaxed and if you get it wrong, who cares (in fact, some friends of mine are blessed with light flows and only change their cup in the shower, like, once or twice a day), but really - it’s not that hard. It’s just a question of habit and understanding how the vagina is shaped and getting comfortable with touching your body on the inside, you know? I think it takes people one to three months to become pros at this thing, and that’s not very long considering we all have cycles for what?, thirty years?, so yeah - it takes a bit of practice, but it’s so worth it.

Personally, I prefer to change at home when I can, because 1) hygiene and 2) my bathroom is so small I can reach the sink from the toilet and clean my cup with running water (if I’m feeling very decadent, warm water), but you can change your cup anywhere. Just remember you’ll need to clean it thoroughly (because if there’s blood on the outside, it will drip on your underwear) so carry some tissues or a small water bottle if you decide to change in a public restroom or outside in the woods or whatever.

Sizes 

It’s true we never think much about it, and vaginas are all different anyway, but your muscles normally get a bit looser as you age (or when you have children if they’re born with a natural birth). For this reason, a menstrual cup comes in two sizes. If you’re under the age of 40 and/or don’t have kids, the smaller size is probably the best choice. Otherwise, try the larger one. Some manufacturers also suggest the larger size for women with a very heavy flow, so there’s that as well. My advice would be, unless you know for sure you’re going to need the larger size (like, if you’ve given birth or something), then try the smaller one first.

And also: in theory, the fact you never used a tampon shouldn’t play a role in your ability to use a cup because they’re two very different objects, but if you have zero experience with inserting things up there, it could feel a bit weird and embarrassing in the beginning. Just remember to relax and take it easy - it may take several tries, over several days, to get this right, and there’s absolutely no shame in it. The first time I decided to insert a tampon I spent about thirty minutes staring at the stupid thing, wondering how the hell it was supposed to fit, and then just put it in the box and walked away. That is normal. 

(Some women also prefer not to use any internal contraptions of any kind, and that’s fine too. It’s your body. Any preference is a good preference. Yes penis and no tampon is fine. No penis and no tampon, also fine. Yes fingers and yes cup but no vibrator but yes penis: very fine. Whatever. You’re in charge.

Just remember one thing: vaginas were designed to get a baby’s freaking head through them, so lack of space is not the problem. If you want to use tampons or cups and find you’re too tight, you’re not, like, biologically tight. What’s happening is, you may be very nervous and stressed (most likely) or you may have vaginismus (least likely). If you can, it’s probably a good idea to discuss this with your ob/gyn.)

Finally, the insertion of any kind of object in the vagina is likely to be umcomfortable or painful if you’re very young and/or a virgin (and that includes menstrual cups). Plus, using tampons, a menstrual cup or an internal vibrator (or even your fingers) may cause your hymen to break. If you live in a country where this bullshit thing still matters, please be careful - the first priority is always to keep yourself safe, okay? Good.

I hope this was helpful? You can find more infos and videos on the manufacturers’ websites: Lunette || Diva Cup ||Organic Cup. And also here’s a fun quiz to help you figure stuff out!

[everyonesfavoritegoldenboy]

She's holding my hands in hers as I sit, dumbfounded and frantic on the couch. I try to pull my hands away, she won't let me...I try to look away...I'm not going to lose it completely on her. I don't know what to think or say...Hell of course she would come running here...she should...it's just a shock to me...but I have to concede that she needs friends and support too...I can't be the selfish bastard in this scenario... even though that's pretty much what I am...I guess.

My eyes water up, but I blink the tear away as Ali makes me look at her. How much does she know?? Does my side even matter? We've been the oldest of friends and I know she can catch me in any bullshit...so I don't even want to try and pad things or sugar coat it...I just wonder how much of my continuing crisis she can handle.

We look at each other for a moment more, and I'm trying to convey everything in my heart to her without saying a word. I didn't tell Amanda I was back in town for so long...and now I realize I didn't tell Ali how far we'd progressed since Amanda found out I was back...things snowballed so quickly I barely had a chance to settle into the notion that we were going to be a couple...and then we weren't...and now...this...that everything had blurred in the process.

Mills finally let my hands slide loose and I scrubbed my face. I let out a bone chilling groan of frustration and leaned back against the couch, staring up at the ceiling. One tear falling from my lash...and I brush it away.

"What do you want me to say, Sis? I'm a complete fuck up...I ruin everything I touch... don't look at me like that. It's true... just look at everything around me...I thought at least...I thought at least everything would be good...you know...with her...she seemed to have wanted us to happen... just as much as I did... what happened, Ali? Where did I go wrong? You're not a shrink...you're my friend...and you're a chick... what is it with you chicks? When you hop on those menstrual cycles or something...you can make a guy's life a living hell."

I look at her and smile a little...if I knew her I was in for a good chew out on the subject of feminism and maxi pads or some other topic I was glad I didn't have a daughter to listen to about this. I have tried to tap into my girlie side, but maybe that's a part of my problem...but maybe she'll go easy on me and just help me figure out why I can't keep a relationship for more than five minutes or find a way to help me get her back...I dunno I'm desperate at this point...I look down at the keychain in my hand and think about Amanda... being here...and where she was now. Was she safe? Was she with him? Does she think about me at all? What can I do?

Pancakes, bacon, and a heart-to-heart

After Amanda leaves I realize I only have half an hour to get Johnny’s breakfast ready. For once in my life I hope my guest is late… but I know how hungry he is in the morning, so that’s not likely.

Having to set the table outside means I have to run back and forth between garden and kitchen a few times, but I manage to get it all ready five minutes before the time. Go, Ali! Being a mom really prepares you for moments like these…

And that’s a good time, because Johnny rings the bell just as I’m putting the last batch of pancakes on a tray. I take off my apron, open the door, and give him a bear hug… he’s going to need the food and the affection, because if yesterday’s talk with Amanda was hard, this is going to be even harder for him.

“Breakfast is in the back garden, as promised”, I say, handing him part of the food. “Here, you take the orange juice and the strawberries, and I’ll take charage of the pancakes. I hope you’re hungry, because I’ve made food for half a dozen people!”

@everyonesfavoritegoldenboy​