# ADD/ADHD in EMS providers



## LucidResq (May 5, 2011)

How many EMS providers have a diagnosis of ADD/ADHD... who is undiagnosed but suspects they may have ADD/ADHD (like for reals... not the jokey "oh look shiney thing!" internet joke BS)? Just curious. I'd also love to hear what medications, therapies, etc those with ADHD have found useful.


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## usalsfyre (May 5, 2011)

Fairly severe ADHD, not diagnosed till adulthood. Making list, minimizing distractions and Straterra have made a huge difference here.


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## LucidResq (May 5, 2011)

Myself - diagnosed at age 14. Symptoms managed with fairly good results for nearly 7 years on Adderall. I went from a 1.6 GPA my freshman year of HS to a 3.6+ within a semester after being diagnosed and put on Adderall. They initially misdiagnosed me as bipolar (put me on Seroquel which was awful!) but quickly came to the conclusion I just had ADHD (the uppness) but got down due to poor performance/grades (downness). Once the grades and social life were improved, what they thought was the down phase of manic depression disappeared.

Still have issues with a few symptoms - primarily extreme hyperfocus (I can research a completely random topic like nobody's business, but have trouble getting bills in on time) and tuning out when my boyfriend is talking, but I think I'm doing relatively ok.


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## usalsfyre (May 5, 2011)

LucidResq said:


> Still have issues with a few symptoms - primarily extreme hyperfocus (I can research a completely random topic like nobody's business, but have trouble getting bills in on time


Same here. OTOH I am a killer at Trivial Pursuit 



LucidResq said:


> and tuning out when my boyfriend is talking, but I think I'm doing relatively ok.


This and outburst were why I went to get tested. Being medicated has probably saved my marriage.

My physician was thinking about Adderal initially, but the stuff scares the crap out of me (family substance abuse history on both sides). Hence why we decided to try non-stimulants first.


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## LucidResq (May 5, 2011)

usalsfyre said:


> Same here. OTOH I am a killer at Trivial Pursuit



Hahaha that's always the best, isn't it? I had a teacher tell me once that even though I wasn't good at much else, I should enter certain contests because I did know completely useless information. 



usalsfyre said:


> My physician was thinking about Adderal initially, but the stuff scares the crap out of me (family substance abuse history on both sides). Hence why we decided to try non-stimulants first



I'm considering have chat with my shrink. I totally don't blame you. I'm reluctant to try something else since the Adderall has managed my symptoms so well, but I'm always crazy-menopausal-hot, and I've even been evaluated in-depth by a cardiologist because they thought I had WPW (pretty sure it was just the amphetamines).


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## exodus (May 5, 2011)

I was actually diagnosed ~5th grade, put on ritalin, then taken off for a reason I dont' remember. Recently started noticing the symptoms again.. I go in Sunday to talk to a shrink about it and possibly get re-diagnosed...


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## Shishkabob (May 5, 2011)

Was diagnosed at a young age, put on ritilin, developed trichotillomania, was taken off ritilin .


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## 281mustang (May 6, 2011)

I've got a pretty bad case of inattentive ADD. I didn't go to a p-doc to get an offical diagnosis until I started Medic school and wanted an Adderall script.

I don't want to take amphetamines long-term so I'll proabably try out some non-stimulent meds after I graduate.


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## medicRob (May 6, 2011)

Diagnosed by a physician several years ago. He is still comfortable in his diagnosis all these visits later. We had to fine tune my medication. However, once we got it right, it helped me greatly. It made the channels stop changng, I could actually focus on one thing instead of jumping from one topic to the next mentally. For once, my dopamine was just right.


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## Sasha (May 6, 2011)

Well I think that---Squirrel!


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## Sasha (May 6, 2011)

See.. my ADHD prevented me from reading your entire first post about shiney things. I've had ADHD since I was a kid, I was on a combination of wellbutrin and concerta at first, because I also had depression or some such. It helped but I took myself off of it. My grades came up and I got frustrated that everyone was attributing my grades to the medication and not to me, who worked her butt off for those grades.

I took myself off the medication and have not gone back on. I know I probably should, but I get by without it and i've heard some horror stories.

I also didn't like how I felt completely zombified by the medication combination and I wasn't sure if it was the wellbutrin or concerta, and am not willing to try either again.


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## harryb714 (May 6, 2011)

I suspect I might have it but am a little afraid to get diagnosed... 
Reasons I think I have it include: 
1) inability to maintain a social life for an extended period 
2) often "tune out" when other people are talking 
3) bad at following complex verbal directions 
4) can't sit/stand still 
5) get very distracted in large social groups and usually "shut down" socially in those situations 
6) doing 100 things at once but never really 100% completing any of them
7) I can't read more than a few paragraphs without wearing ear plugs
8) I often have to re-read a paragraph I just read because I was thinking about something else while I read


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## mycrofft (May 6, 2011)

*Post one about Asperger's SYndrome*

 .......


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## Blood (May 6, 2011)

harryb714 said:


> 8) I often have to re-read a paragraph I just read because I was thinking about something else while I read



I do that constantly lol.

Anyone else always have a million internet tabs up because they can't focus on just one thing? I constantly open new tabs especially with threads because something looks interesting.


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## 281mustang (May 6, 2011)

Blood said:


> I do that constantly lol.
> 
> Anyone else always have a million internet tabs up because they can't focus on just one thing? I constantly open new tabs especially with threads because something looks interesting.


 I've been online for about an hour. 4 windows with a 2-4 tabs per window.:wacko:


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## DesertMedic66 (May 6, 2011)

harryb714 said:


> I suspect I might have it but am a little afraid to get diagnosed...
> Reasons I think I have it include:
> 1) inability to maintain a social life for an extended period
> 2) often "tune out" when other people are talking
> ...



#7 and #8 always happen to me. I have to have it quiet when I read more then one paragraph or else I won't understand anything I read. And sometimes I'll read something pause and say to myself "what did I just read?". But I don't think I have ADD or ADHD


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## Aidey (May 6, 2011)

medicRob said:


> For once, my dopamine was just right.



lol, I'm glad I'm not the only one who thinks of it this way. I've been known to say "My dopamine is out of whack" when I'm having an off day.

Diagnosed as an adult about 2 years ago. I got my medications sorted out pretty quickly and it made a world of difference. I still have some bad days, but overall I feel much, much better.


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## YCALR (May 8, 2011)

Diagnosed this year and have been prescribed low dose adderall. I've always had the focus issue and always felt as if my mind was running a million miles a second. I couodnt even shut my mind off when it was time to sleep, which caused sleep issues. Since I've been on adderall I have noticed a huge positive difference in my life.


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## rmabrey (May 9, 2011)

I was diagnosed at a young age. Meds never really helped. I find the best way to stay attentive in class is to really participate in the discussion. Some teachers get annoyed, but it really works in my medic classes


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## RanchoEMT (May 24, 2011)

harryb714 said:


> I suspect I might have it but am a little afraid to get diagnosed...
> Reasons I think I have it include:
> 1) inability to maintain a social life for an extended period
> 2) often "tune out" when other people are talking
> ...



You've read my mind, and then had to read it again.... This is exactly me as you described... Even socially. I have a very short attention span and I find I almost need to trick myself into "feeling" the subject/task I'm involved in... i.e. Whenever I study EMT/Paramedic stuff' I have to watch Emergency or some inspiring medical show and then turn it off and sit in complete silence to study... I haven't read beyond this post, I'm wondering what you've done for improvement... I will ask later if not stated further in the forum...


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## RanchoEMT (May 24, 2011)

Aidey said:


> lol, I'm glad I'm not the only one who thinks of it this way. I've been known to say "My dopamine is out of whack" when I'm having an off day.
> 
> Diagnosed as an adult about 2 years ago. I got my medications sorted out pretty quickly and it made a world of difference. I still have some bad days, but overall I feel much, much better.



Which Drugs??? I'm thinking of getting checked out myself.


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## medicRob (May 24, 2011)

RanchoEMT said:


> Which Drugs??? I'm thinking of getting checked out myself.



Adderall, Vyvanse, Methylphenidate, Concerta, Focalin, Dexedrine, Straterra

However, it is important to note that in most situations, you aren't just going to walk in and magically get an ADD diagnosis. Mine took a year. I went to a doctor, told him I was having extremely hard times studying, inattention, etc. He told me there was nothing he could do til I saw a psych professional about it. The psych professional and I spoke in sessions for quite sometime before he realized that it wasn't stemming  or rooted in anything else, that it was physiologic in nature. He then wrote up a recommendation-referral /w medical necessity to the physician who referred me to him, recommending the meds I am on. It took over a year of counseling sessions before they started my medication regimen. 

Also, a lot of physicians are just as hesitant to prescribe Adderal (D-Amphetamine) because just as the name suggests, it is a very addictive stimulant when taken in doses above that which it is intended. Not to mention, if you have any cardiac history, ongoing medical conditions, etc.. he/she might also have issues.


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## LucidResq (May 24, 2011)

Yeah, and like most drugs, there are side effects too, of course. I've been happy enough with Adderall to stay on it for 6 years but when I first started I lost weight at an unhealthy, rapid rate (around 5 lbs a week at one point). Still have dry mouth, palpitations occasionally and borderline-trichotillomania.


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## 46Young (May 24, 2011)

harryb714 said:


> I suspect I might have it but am a little afraid to get diagnosed...
> Reasons I think I have it include:
> 1) inability to maintain a social life for an extended period
> 2) often "tune out" when other people are talking
> ...



2,3,4,6,7, and 8. My saving grace in school is my above average retention ability. I can usually get things on the first or second pass. Otherwise, it would be ugly.


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## RanchoEMT (May 24, 2011)

LucidResq said:


> Yeah, and like most drugs, there are side effects too, of course. I've been happy enough with Adderall to stay on it for 6 years but when I first started I lost weight at an unhealthy, rapid rate (around 5 lbs a week at one point). Still have dry mouth, palpitations occasionally and borderline-trichotillomania.



As in your balding? Or your pulling out your hair???? My father has an official 'hair island' on top of his head... Like Rob Corddry used to have.  I'm not looking forward to my 40's.... If taking Adderall is gonna quicken that process i feel it be best avoided...


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## RanchoEMT (May 24, 2011)

medicRob said:


> was having extremely hard times studying, inattention, etc.
> 
> It took over a year of counseling sessions before they started my medication regimen.



How do you feel now? I feel like my brain is just "uninterested in stress" and actually has a "Fuk-It" Mode, which turns off my ability for 'input' in stressful situations.
Example: I'll have a stressful task in front of me, like studying for a Final Exam and even a week out, I just can't seem to concentrate on it.

I think somewhere along the line my brain noticed I do best when not worrying/focusing too much on something... Bills, Girls, Sex, EMS, Death, Philosophy, etc...
-Brain Says: Whats the point of worrying? There is no benefit in these situations, and from then on a flip was switched off.... But the switch that controls the mini-stress' like waking up on time, paying bills, calling people on there birthday, studying for tests, etc. also seems to be turned off. Tho it is needed to function.

Ha! Your an NP now yes?? Let's do an OnLine Consultation, you can email me the prescription.


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## usalsfyre (May 24, 2011)

I wonder how fast a pharmacist would call the DEA on that...


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## LucidResq (May 24, 2011)

RanchoEMT said:


> As in your balding? Or your pulling out your hair???? My father has an official 'hair island' on top of his head... Like Rob Corddry used to have.  I'm not looking forward to my 40's.... If taking Adderall is gonna quicken that process i feel it be best avoided...



Not balding. I compulsively and unconsciously stroke my hair and occasionally pull pieces out, which I never did prior to taking Adderall. I'm fortunate to have avoided true trich, because many people with it pull their own hair out until they have bald patches or become entirely bald.


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## abckidsmom (May 24, 2011)

LucidResq said:


> Not balding. I compulsively and unconsciously stroke my hair and occasionally pull pieces out, which I never did prior to taking Adderall. I'm fortunate to have avoided true trich, because many people with it pull their own hair out until they have bald patches or become entirely bald.



A friend's daughter pulled out her eyelashes after she started an ADHD med.  Talk about adding stress into a kid's life!


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## RanchoEMT (May 24, 2011)

Anybody use *Ritalin*? 
I've always wanted to o.d. and re-read the Critique of Pure Reason without bleeding from the ears...


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## Chief Complaint (May 24, 2011)

RanchoEMT said:


> Anybody use *Ritalin*?
> I've always wanted to o.d. and re-read the Critique of Pure Reason without bleeding from the ears...




Lol.  I used Ritalin as a kid and it worked wonders for me.  Only needed it for a couple of years though.

When i started medic school, i was having a hard time concentrating so i went to my doctor.  I told him that i wasnt interested in anything with amphetamines in it and he put me on a drug called Nuvigil (same as Provigil but with a longer half life...i think).

The stuff works very well, but i only take it occaisionally.  Its also used to treat narcolepsy, and is given to Air Force pilots who have to fly extra long missions.  Safe to say that it makes getting to sleep at night a bit difficult.


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## medicRob (May 24, 2011)

usalsfyre said:


> I wonder how fast a pharmacist would call the DEA on that...



Let's not find out. ha ha. the ink hasnt even dried on my certificate of fitness yet.


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## Aidey (May 24, 2011)

RanchoEMT said:


> Ha! Your an NP now yes?? Let's do an OnLine Consultation, you can email me the prescription.



Some states require an MD to sign off on any Schedule II RX, so even if the DEA didn't have a problem with it you may still be SOL.


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## Aidey (May 24, 2011)

I received my diagnosis fairly quickly, but my situation was a little  different because the chance of the symptoms being something else had  already been addressed.

 My main med is Methylphenidate extended release, which is a generic  version of Ritalin. My psychiatrist initially tried me on the regular  release stuff and I was way to up and down. I could tell pretty much  exactly when it was kicking in and wearing off. Working in the job we do  taking a pill every 4.5 hours doesn't work very well. I've now been on  the same meds for roughly a year and a half with no plan to change them.


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## Deltachange (May 24, 2011)

ADHD, diagnosed eight years ago at eleven. Put on welbutrin but hated the side effects, got taken off, never did the adderal thing. Now I self medicate with caffeine when needed. Got through basic school just fine, hopefully the same can be said for medic school in a few years. But I get stuck on wikipedia loops, and know more useless facts than my high school's trivia team. It helps that EMS and the human body is so fascinating, I can hyperfocus on stuff that is relevant to my job/education.


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## medicRob (May 24, 2011)

Aidey said:


> Some states require an MD to sign off on any Schedule II RX, so even if the DEA didn't have a problem with it you may still be SOL.



I am authorized in my particular medical center to prescribe as I see fit, schedule II included. However, we are of course required to take into consideration: Rational Drug Selection (For instance, not writing Percocet when Toradol can do the job), Pharmacoeconomics, and just a little bit of common sense. 

However, I work in acute care in the trauma unit, so after-care prescriptions are usually written by our surgical stepdown docs and NPs. However, there are a few situations where I can follow up. When those situations present themselves, I always find it judicious to consult with my advanced practice and MD colleagues when necessary. 

In summation, while I can in fact write scripts, doing so outside the Practitioner patient relationship is a big "No No" and could result in action by my employer, the state board, the DEA Diversion Control Office, and could result in formal charges being filed, ... so that's a big no, or as the above poster put it, "You're SOL".


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## Aidey (May 24, 2011)

My guess is that it varies state to state. When I was working in a GP clinic if one of the NPs or PAs wrote for any Schedule II meds the MD working there had to sign the RX also.


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## RanchoEMT (May 25, 2011)

medicRob said:


> ... so that's a big no, or as the above poster put it, "You're SOL".


 Expectations weren't very high to begin with... ^_^


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## RanchoEMT (May 25, 2011)

Chief Complaint said:


> Lol.  I used Ritalin as a kid and it worked wonders for me.  Only needed it for a couple of years though.
> 
> When i started medic school, i was having a hard time concentrating so i went to my doctor.  I told him that i wasnt interested in anything with amphetamines in it and he put me on a drug called Nuvigil (same as Provigil but with a longer half life...i think).
> 
> The stuff works very well, but i only take it occaisionally.  Its also used to treat narcolepsy, and is given to Air Force pilots who have to fly extra long missions.  Safe to say that it makes getting to sleep at night a bit difficult.



So kinda like speed?? You say you take as needed?? "occaisionally" How does that work? Like you have a test or class your taking and you start popp'n?


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## medicRob (May 25, 2011)

Aidey said:


> My guess is that it varies state to state. When I was working in a GP clinic if one of the NPs or PAs wrote for any Schedule II meds the MD working there had to sign the RX also.



Actually, it is not even state to state. It is physician to physician. I work under Critical Care Surgeons in a Trauma I, I am given a little bit more authority than you would see in a nurse practitioner in a lot of situations. It all comes down to: 

A. What your state says you can do
B. What your facility says you can do
C. What your overseeing physician says you can do


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## harryb714 (May 25, 2011)

RanchoEMT said:


> You've read my mind, and then had to read it again].... This is exactly me as you described... Even socially. I have a very short attention span and I find I almost need to trick myself into "feeling" the subject/task I'm involved in... i.e. Whenever I study EMT/Paramedic stuff' I have to watch Emergency or some inspiring medical show and then turn it off and sit in complete silence to study... I haven't read beyond this post, I'm wondering what you've done for improvement... I will ask later if not stated further in the forum...



I haven't really done anything for improvement.  But it has been reassuring to see that you (and a few others) have similar issues.


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## harryb714 (May 25, 2011)

46Young said:


> 2,3,4,6,7, and 8. My saving grace in school is my above average retention ability. I can usually get things on the first or second pass. Otherwise, it would be ugly.



My retention ability is also what saved me in school.


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## phideux (May 25, 2011)

I think I had ADHD and ADD growing up, but I got the permanent cure. I went to Catholic grade school, in the 70s, with the nuns and their rulers.
Them nuns work better than any drug you could think of.


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## SFox3325 (Jun 30, 2011)

Me, ADD since 14, but out grew it?  At least that's what our family MD told my parents at the time.  My Brother, had ADHD, and still struggles with it to this day.


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## Luisgecarr (Aug 1, 2016)

Hello, I am a current wheelchair driver and I want to become an EMT.  I recently took a drug test and told the nurse I take vyvance.  She told me that I was not allowed while being both a wheelchair and ambulance driver; however, when I told the doctor at the drug test facility she informed that I was allowed as long as I show that I am being controlled by my doctor. I also asked at the DOT here in Florida and they told me it was ok.

Where kind I find written prove that I can work while being prescribed to my employer?

Thank You.


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## sack jears (Oct 3, 2016)

They thought I had ADD but i turned out to have bipolar disorder. Whole other can of worms right there


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## TransportJockey (Oct 4, 2016)

sack jears said:


> They thought I had ADD but i turned out to have bipolar disorder. Whole other can of worms right there


This, ADD, and borderline personality disorder seem to have huge percentages in EMS compared to the general population.


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## sack jears (Oct 6, 2016)

TransportJockey said:


> This, ADD, and borderline personality disorder seem to have huge percentages in EMS compared to the general population.


Gotta be a little crazy to do this gig haha


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## Summit (Oct 6, 2016)

281mustang said:


> I've been online for about an hour. 4 windows with a 2-4 tabs per window.:wacko:


On average I have 50+ tabs open
ADD here!

Nursing has a lot of crazy too.


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## Summit (Oct 6, 2016)

46Young said:


> 2,3,4,6,7, and 8. My saving grace in school is my above average retention ability. I can usually get things on the first or second pass. Otherwise, it would be ugly.


Yep! Same here!


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## NomadicMedic (Oct 6, 2016)

I know we're joking around about this, but I will say, without any reservation, I had no idea what normal felt like until I started taking Ritalin. It's a game changer in the way I am able to focus and complete projects. I no longer feel drawn in a thousand different directions. It has made a huge difference at work. It's not without side effects and titration of the dose is important, but it's good stuff if you truly need it.


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## Never2Old (Oct 6, 2016)

I can sum up my ADD in this quote ... " I have found that a great deal of the information I have was acquired by looking for something and finding something else on the way."

Although I have to admit, I think it makes me a better Paramedic in the end by the way I am able to handle lots of spinning plates and still get the hyper-focus when I need to.


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