Corpus

I think this is a good answer. However, a clinical exam is necessary before going on to imaging, which, if their are no signs of chronic liver disease, is not typically indicated provided that the raised bilirubin is largely indirect (unconjugated),and the FBC/reticulocyte count are normal excluding hemolysis. A urine dipstick demonstrating no bilirubin and low levels of urobilinogen also points towards Gilberts. A serum iron level and blood ferritin are necessary to get more details of the raised Transferrin Saturation, and finding out if there is any history of hemochromatosis in the family is necessary. If the iron studies suggest iron overload then an ultrasound would not give you the resolution you would need to establish any liver damage; an MRI would be preferable. If everything points to Gilberts then repeating the bilirubin level after a period of fasting would cause it to rise further which is effectively diagnostic of Gilberts. Why were these tests done? Any symptoms of any nature? And it is good to see another medical doctor here. Remember, according to Leo, we are "the worst".

Ketamine is seriously impressive but there are (or have been) better longer-acting agents with very similar effects. MXE was preferable in this regard, IME. If you compare ones thinking when in the normal state compared to on a classic psychedelic such as psilocybin/LSD, a useful metaphor might be to compare the latter state as "3-dimensional" compared to the normal "2-dimensional" way of thinking. I find that agents like MXE/ketamine "create a 4th dimension" which goes as deep again beyond the conventional agents (LSD/psilocybin). It is not possible to intuit this mode without having experienced it, irrespective of how many acid/mushroom trips one may have taken. In terms of effecting personal behaviour change I find the class of drugs which ketamine/MXE belong to far exceed the capacity of LSD/psilocybin to produce enduring change. And that is saying a lot. A fantastic book which explores what ketamine can achieve in terms of consciousness work is "The Scientist- A Metaphysical Autobiography" by Dr John C Lilly.

I find 5 MeO DMT has some really enigmatic properties. The immediacy of its effects when vaped on dissolving the sense of self to the extremely clarified state it reliably produces becomes utterly natural to surrender to in my personal experience. So much so that I quake internally much more when presented with a dose DMT these days. A real paradox at work if we consider that the power of the former (5 MeO) exceeds that of the latter. And then the notion of power itself gets transcended. I am fully able to appreciate how Martin Ball vaped hundreds of doses of the stuff these days. I also would state without hesitation that vaporizing DMT on the back of full MAO-A inhibition is a much more challenging endeavour than vaping 5 MeO DMT by a clear mile, IME.

Again, see how hung-up you are on the words? You may be happier if "ego-death" as a descriptor were used but the ego is not alive so cannot die if we consider death and life as opposite counter-points. Ego-death means different things to different readers so the limits of language are not done away with. You appear to think language can transmit in an absolute fashion. That may be the source of the disquiet these communicative efforts are producing in you. Language clarifies, but only through the prism you receive or view it through. It is a canny invention. If you think reading some text will give a definitive "answer" to an issue then you are missing what is beyond language. You may well have read something in the past, say a text or an item of literature, and then read it again at a later time and gleaned something new or previously unrecognized from the very same "bunch of words". Your thought-stream is not wholly different as its a linguistic construct. Confusion does not have to be the enemy as without it newer perspectives will not be sought or realized. Embrace your confusion!

The contradictions arise as a consequence through, and as a function of, language; if the comments were read out loud then with a little contemplation it becomes apparent that the sound of the words uttered are a means of representation of ideas whereby meaning is applied and conferred to what are simply sounds. What is probably meant by "die" refers to death of the ego; if one contemplates further then one may discern that the ego is not actually alive, and hence subject to dying so the whole notion is a linguistic quirk which comes with the use of language. Hence the only real way to grok this stuff is to understand how language creates and limits the transmission of ideas. Ways of knowing are accessible which can transcend language, and attempting to experience stuff through a linguistic mode only will hamper progress.

The efficacy of plugging is highly variable. Correctly vaped, and that is not a given, then 6-8mg will be a substantial experience with the advantage of a shorter duration which is sensible for a first go. If snorted I would suggest around 10-12mg only.

Strictly from a neuroscience perspective, deja-vu (and its corollary jamais-vu) is seen with seizure activity within the temporal lobes of the brain.

@Leo Gura Nice generalization. There may well come a time when you revise this stance.

As a doctor here, you offer me no new insight. The question is, and its perhaps doing a poll on, what proportion of those using 5 MeO DMT rectally are having the kind of experiences that you are, and what proportion find it to be ineffective or very inefficient in terms of dosages required. And to get more data, perhaps ask the same question but pertaining to insufflated 5 MeO DMT?

@Leo Gura, why is the suggestion I offered dumb? You may be a master "rectal-naut" but perhaps consider how your experiences have not been repeatedly confirmed by others, whereas the snorted routes' success with 5 MeO DMT was well established before you even became aware of the compounds existence. You have been known to ascribe this variation in rectal absorption to genetics but it is worth considering that even with genetics being deemed responsible there are no reports of insufflated 5 MeO DMT not working.

Forget what you have "heard" about plugging; the success rate with snorting is much higher if your substance is as labelled.

LSD and other ergot derivatives have a pressor effect which produces a degree of vasoconstriction; if one is not sufficiently relaxed this will cause the BP to rise. However, a transient mild BP rise would not typically detach ones retina unless there are other co-existent conditions.

Snort it, if it is HCl.

"Powerful" has many connotations. Irrespective of what the descriptor "means" to the one asking the question, you would not be felt to be short-changed by vaporhuasca (vaporized DMT on the back of full MAO-A inhibition) or the combination of a long-acting NMDA receptor antagonist with LSD/psilocybin. These examples IME, particularly vaporhuasca, exceed what 5 MeO DMT provides. But these evaluations are subjective.

I wonder if I could share a solid insight I have had, pertaining to that "undeniable" sense of being a person inside of ones head, and its genesis. Before attempting to convey this, it must be stated that to investigate a matter it can be useful to recognise the foundational assumptions one has in place and to consciously regard them as provisional, and a launch-pad for the investigative process. I am sure that many in the early part of the work will have encountered the "VHtG" sense I refer to, and the abbreviation can be deduced from viewing the title of this post. Those further in the work will know this to be illusory, and yet stating it thus is of little help (apart from perhaps engendering tension and frustration- both worthy of investigation in their own right) to those who are confronted by what appears to be, and feels like, a "thing". Being able to inspect its genesis and components I hope will be of use to somebody. Let us start with the assumption that we are inside our brains, behind the eyes, peering out onto a world of objects which presents a changing vista within which we as separate individuals have to interact to survive, get our needs met and generally pass time until we die. This external world is the one that we (according to the assumption) perceive by virtue of our perceptive organs, and apply analysis to, to construct a meaningful narrative which becomes our story, and the story of reality. This narrative is largely composed of the inner dialogue (the thoughts) which overlies our feelings which (as per the assumption) also resides in our brains/minds, and have as part of their input the somatic neural afferent impulses which are sent up the spinal cord and into the brain. When we are in the process of day-dreaming, resurrecting our memories or imagining future outcomes/scenarios, the "inner-minds' eye" produces visual imagery which when really considered deeply is nothing but a facsimile of what has been perceived (as per the assumption- for now) previously, accurate enough to fly under the radar of true scrutiny, and held to be an accurate representation/projection. Yet beyond this, the facsimile is remarkably creative in that it has ingredients imposed as inherent in the facsimile which are re-presentations of the other sensory perceptions/modalities, which imbue a sound-track, emotional overtone, and if required a kinesthetic, olfactory, gustatory or somatic sensory component. In essence, ones inner life, is the creative combining of prior sensory experiences to produce an inner world. You may have never seen a pink elephant but your "mind" can produce the imagery of one, by this creative process. When we peer out at the world, most will typically have a sense of being behind ones eyes, surveying the scenery of what is presumed to be an external solid world that exists in its own right whether or not we are viewing it. This sense has a true "feel" to it, and this is the "UNDENIABLE" part of it. Whilst being purely conceptual, this concept is "projected inwards" as it were as a facsimile, into the brain/skull (as the assumption maintains) , where it becomes a nidus around which ones feelings and inner dialogue swirl, and the combination of these components is what the VHtG sense is composed of. And to add another layer of veracity to the illusion, which is typically overlooked, is ones inner dialogue is composed of language, a tool which only exists as a communication device between self and other, thereby reinforcing in an underhand but creative fashion the notion that the illusion is real. A pearl can be created from a grain of sand around which accretions are laid down producing a thing of beauty. Consider the perceptual mimic of peering out from behind ones eyes as akin to the sand, and the self the beautiful pearl that magically embellishes it. Of course, this work is in many ways a step-wise process of investigation and deconstruction, and this insight is only a single step along the way. For me, this insight has proved very useful and I hope others get something from it.

ECT is particularly effective in the elderly patient with severe depression with psychomotor retardation and such patients are often diagnosed with other conditions which in themselves or as a consequence of the treatment may preclude the use of psychedelics.

Perhaps, whilst the experience is "on"; however, the candyflip if done repeatedly can produce a confusing depressive episode 3-4 days later. A fine experience but one which should be visited infrequently.

I think some dangerous situations are "imposed from the outside", and the ego, which is much like a personalised navigation/advisory function, kicks in to direct its holder/bearer to take the appropriate action to protect itself and also that which it could not "exist" without, namely the body. Its ability to guide and advise is not objective, and the suggestions it provides are experientially constructed as a form of learning.

I think the Serenity Prayer may have something to add to this discussion. I left a well-paying position after over a decade and this stemmed from plucking up the courage to make the change when acceptance of the observation that the environment and set-up I was mired in cared very little for any attempts to do the job to the highest standards, and any amount of gentle persuasion, attempts to draw attention to clear failings, and downright complaining made no difference whatsoever. Taking a meta-view of matters would not alter the reality on the ground and for my own well-being moving away, whilst initially difficult, has led to finding a niche where maintaining ones integrity towards ones work became possible. This was the only "domain" in my life which elicited complaining of any magnitude, and by virtue of all that is Good, it is a novel and invigorating situation when one can thoroughly enjoy doing what one has spent many hard years of training to do, and to be able to honestly say that there is absolutely nothing about my life which needs to be complained about either reflexively or "consciously".

In my estimation, if one has experienced (in general terms) psilocybin or ayahuasca (and also LSD or mescaline) there are commonalities between them all in terms of what is revealed; 5 MeO DMT leads to a domain which is distinct from the afore-mentioned, certainly when vaporized at release doses, because in part the inner dialogue is largely abolished rather than associatively loosened as with the usual agents. The visual aesthetic is also different with 5 MeO DMT and hence it really is a unique substance which is perhaps incorrectly "lumped together" by some with all the others.

"Mega"-dose could also apply to the qualitative aspects of a trip. In this regard, psilohuasca is very worthwhile an endeavour. There are more subtle aspects to tripping beyond just taking a shovel-full. 5g of dried shrooms with full MAO-inhibition was, for me, really really deep but with an immense degree of clarity which I found was absent with more grams of mushrooms without the augmentation.

It is your choice to call it pain rather than suffering but this is more of a definitional issue, and open to discussion. Also recognise that Stephen Hawkings' phenotype of MND is a real rarity and does not reflect the picture I paint of the reality of the condition for many. As an outlier, his case cannot be a reasonable yardstick.

What if suffering was considered another way, as enduring an unwanted circumstance which in the setting of MND could include hypersalivation and an inability to swallow or spit it out, lacking the gag reflex to prevent it from trickling into ones lungs along with an inability to vocalise ones distress nor enrol the assistance of others, a perpetual sensation akin to drowning but, as you state, being unable to complain about it (due to an inability to speak) is a kind of blessing because it creates no additional unnecessary suffering? Never/Always have much in common with should/could/would and their opposites. Could this "never" be suspended before the inevitable suffering arrives, with the taking of ones life before the suffering kicks in? Having spoken to a number of such patients it is far from uncommon for them to express the wish to have recourse to this path of action, and I personally can see why they feel this way.

Perhaps visiting a ward containing patients with the different types of motor neurone disease could allow this dogmatic position with its "never" to be reconsidered?

I think there is a time and place for the full range of agents, and each adds its own flavour to the trip delivered. I do not find them inferior to say vaporized DMT or 5 MeO DMT. Combining agents of different classes and using MAO-inhibitors just broadens the menu further, as it were.