Forums > Social Discussion > Psychotic Kid
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HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
So today I'm working in the ER trying to flush the wax out of a kid's ear so I can tell whether he's got an ear infection or not (he did) when I hear a crash and then a kid's voice yelling "NO!" and then I see a grey flash go past my room.
Well this is all very interesting... And someone says "Catch him!" "I can't he kicks!" "What's been going on, mommy?" "I'm his foster mother. There was some sort of medication they were supposed to send me. I've had him for two weeks and I don't have the medication yet and now he's been like this for two days!" "You lived like this for two days?"
The medication, it turns out, is haloperidol, an antipsychotic.
At this point I excuse myself from my patient, grab a blanket, find the kid on the Adult side of the ER and say "sorry, kiddo, but I'm gonna have to catch you." and wrap the blanket around him. This FIVE YEAR-OLD CHILD... He kicked, he SPAT, he tried to bite me. He scratched me. Definately kicked the living daylights out of my shins. Left me bruises, he did.
So the big, strong, African-American nurse, Monique, and I wrestle the kid onto an exam table and properly wrap him in a blanket, thereby immobilizing his arms and legs. Then we put a TB mask over his face to deal with the spitting and biting attempts.
And then she grabs the head and body and I grab the kicking legs and we carry this FIVE-YEAR-OLD boy (strong lil' one he was, too) kicking and struggling out of the ER towards the Psych ER. And no sooner had we started to move than he screams out "YOU MOTHER
!!!! You fcking Bih!!!" I think I also got called a "st-faced mother 'arse'hole." BY A FIVE-YEAR-OLD BOY!!!
Well we walk this cussing, struggling, bundled boy throught he hospital to the psych ER (imagine the scene: Now you're some poor schmuck civilian walking into a hospital for whatever reason at 10:30 at night and here come a nurse and doctor carrying a bundled and masked child yelling profanities that would make a 20-year-old sailor blush down the hall of this hospital...just put this in your head. And you can imagine why I was struggling not to bust up howling in laughter at the situation). At the ER we were greeted by an ENORMOUS African-American police officer. And so we get the kid in a chair and the cop puts the kid's feet on his lap. I say "mind the feet!"...but too late and then the cop got it in the chin. So the shoes came off.
And now we have this big black cop and this rather well-muscled doctor holding down this struggling boy who's still trying to spit while hurling rather advanced profanities. And this cop and I are looking at each-other not quite sure what to make of all this. The cop challenged the boy to spell his profanities... The boy TOTALLY didn't get the idea that he wasn't going to win a fight against two big, strong grown men. I have to give him points for persistence.
I mean I feel terribly for the boy. He's psychotic. It isn't his fault or the fault of bad parenting; he was born with a bad brain. And he's NEVER going to be OK.
And I *REALLY* hope they get his psychiatric management sorted by the the time he's a teenager. Because all evidence is that he's going to be a BIG kid...
So today I'm working in the ER trying to flush the wax out of a kid's ear so I can tell whether he's got an ear infection or not (he did) when I hear a crash and then a kid's voice yelling "NO!" and then I see a grey flash go past my room.
Well this is all very interesting... And someone says "Catch him!" "I can't he kicks!" "What's been going on, mommy?" "I'm his foster mother. There was some sort of medication they were supposed to send me. I've had him for two weeks and I don't have the medication yet and now he's been like this for two days!" "You lived like this for two days?"
The medication, it turns out, is haloperidol, an antipsychotic.
At this point I excuse myself from my patient, grab a blanket, find the kid on the Adult side of the ER and say "sorry, kiddo, but I'm gonna have to catch you." and wrap the blanket around him. This FIVE YEAR-OLD CHILD... He kicked, he SPAT, he tried to bite me. He scratched me. Definately kicked the living daylights out of my shins. Left me bruises, he did.
So the big, strong, African-American nurse, Monique, and I wrestle the kid onto an exam table and properly wrap him in a blanket, thereby immobilizing his arms and legs. Then we put a TB mask over his face to deal with the spitting and biting attempts.
And then she grabs the head and body and I grab the kicking legs and we carry this FIVE-YEAR-OLD boy (strong lil' one he was, too) kicking and struggling out of the ER towards the Psych ER. And no sooner had we started to move than he screams out "YOU MOTHER
!!!! You fcking Bih!!!" I think I also got called a "st-faced mother 'arse'hole." BY A FIVE-YEAR-OLD BOY!!!Well we walk this cussing, struggling, bundled boy throught he hospital to the psych ER (imagine the scene: Now you're some poor schmuck civilian walking into a hospital for whatever reason at 10:30 at night and here come a nurse and doctor carrying a bundled and masked child yelling profanities that would make a 20-year-old sailor blush down the hall of this hospital...just put this in your head. And you can imagine why I was struggling not to bust up howling in laughter at the situation). At the ER we were greeted by an ENORMOUS African-American police officer. And so we get the kid in a chair and the cop puts the kid's feet on his lap. I say "mind the feet!"...but too late and then the cop got it in the chin. So the shoes came off.
And now we have this big black cop and this rather well-muscled doctor holding down this struggling boy who's still trying to spit while hurling rather advanced profanities. And this cop and I are looking at each-other not quite sure what to make of all this. The cop challenged the boy to spell his profanities... The boy TOTALLY didn't get the idea that he wasn't going to win a fight against two big, strong grown men. I have to give him points for persistence.
I mean I feel terribly for the boy. He's psychotic. It isn't his fault or the fault of bad parenting; he was born with a bad brain. And he's NEVER going to be OK.
And I *REALLY* hope they get his psychiatric management sorted by the the time he's a teenager. Because all evidence is that he's going to be a BIG kid...
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
SILVER Member
veteran
1,433 posts
Location: 8 days at Cloudbreak, 6 in Perth, Australia
veteran
1,433 posts
Location: 8 days at Cloudbreak, 6 in Perth, Australia
Posted:
Holy sounds like one hell of an adventure for you!
Poor kid though probably didn't really know what he was doing...I hope they can get him the help that he needs, whatever that may be.
Holy
sounds like one hell of an adventure for you!Poor kid though probably didn't really know what he was doing...I hope they can get him the help that he needs, whatever that may be.
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
No, I mean...no mentally intact 5-year-old fights with a cop.
No, I mean...no mentally intact 5-year-old fights with a cop.
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
Carpal \'Tunnel
7,193 posts
Location: in the trees
7,193 posts
Location: in the trees
Posted:
pint sized hannibal lecter
pint sized hannibal lecter GOLD Member
hehe, 'Member' huhuh
6,120 posts
Location: Behind you. With Jam
hehe, 'Member' huhuh
6,120 posts
Location: Behind you. With Jam
Posted:
Hannibal Lecter was more cultured and eloquent....
Hannibal Lecter was more cultured and eloquent....
"I used to want to change the world, now I just wanna leave the room with a little dignity..." - Lotus Weinstock
BRONZE Member
Carpal \'Tunnel
5,814 posts
Location: Perth, Australia
Carpal \'Tunnel
5,814 posts
Location: Perth, Australia
Posted:
Sounds like alot of it is out of the childs control. What hell the foster carer is going through.?
Restraining a completely out of control young child is insanely hard. They have no compuunction against bitting headbutting and kicking as hard as they can and its like holding an eel.
As you say as he gets bigger and stronger its going to get worse. I wonder what his history is, whether there is drug abuse in pregancy or what the chemical cause is.
Keep in training o muscley doctor. Glad all that jelly wrestling come in handy. Well done.
shoot Lightning with jelly gun
Sounds like alot of it is out of the childs control. What hell the foster carer is going through.?
Restraining a completely out of control young child is insanely hard. They have no compuunction against bitting headbutting and kicking as hard as they can and its like holding an eel.
As you say as he gets bigger and stronger its going to get worse. I wonder what his history is, whether there is drug abuse in pregancy or what the chemical cause is.
Keep in training o muscley doctor. Glad all that jelly wrestling come in handy. Well done.
shoot Lightning with jelly gun
Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?
Im in a lonely battle with the world with a fish to match the chip on my shoulder. Gnu in Binnu in a cnu
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
Oh yeah, there was nothing calculating or cold about it. He was just berserk. I mean, there was enough executive function in there for him to try to bite, but clearly his brain is incapable of thinking more than two or three seconds into the future.
Or a struggling bag of rice
HEY!!!!
Written by: Gnor
Sounds like alot of it is out of the childs control. What hell the foster carer is going through.?
Oh yeah, there was nothing calculating or cold about it. He was just berserk. I mean, there was enough executive function in there for him to try to bite, but clearly his brain is incapable of thinking more than two or three seconds into the future.
Written by:
Restraining a completely out of control young child is insanely hard. They have no compuunction against bitting headbutting and kicking as hard as they can and its like holding an eel.
Or a struggling bag of rice
Written by:
shoot Lightning with jelly gun
HEY!!!!
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
No, Lecter was far scarier. He was cool and cold and calculating. That's why his character is so disturbing. It's the mental aspect that made Lecter such a terrifying figure. An out-of-control animal is predictable. Physically taxing to control, but predictable. And the predictable isn't scary.
But this was SOMETHING, let me tell you... Add this to my list of "stories of messed-up things I've seen in my job." Any doctor has a bunch of them.
Written by: ravehead
No, Lecter was far scarier. He was cool and cold and calculating. That's why his character is so disturbing. It's the mental aspect that made Lecter such a terrifying figure. An out-of-control animal is predictable. Physically taxing to control, but predictable. And the predictable isn't scary.
But this was SOMETHING, let me tell you... Add this to my list of "stories of messed-up things I've seen in my job." Any doctor has a bunch of them.
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
Carpal \'Tunnel
7,193 posts
Location: in the trees
7,193 posts
Location: in the trees
Posted:
i remember when i fractured my skull as a kid and it took 2 off duty cops, two nurses, my dad and a porter to hold me down
i remember when i fractured my skull as a kid and it took 2 off duty cops, two nurses, my dad and a porter to hold me down SILVER Member
Carpal \'Tunnel
3,533 posts
Location: Hampshire College, MA, USA
Carpal \'Tunnel
3,533 posts
Location: Hampshire College, MA, USA
Posted:
That's pretty impressive. It really makes you feel lucky that we were all born with both wits tied down. The poor kid probably doesn't have too much of a future unless that medication works miracles. I hope that poor foster mother is compensated for her troubles somehow, and I really hope she doesn't take legal action against whatever agency landed her with the kid, because she certainly has grounds to.
That's pretty impressive. It really makes you feel lucky that we were all born with both wits tied down. The poor kid probably doesn't have too much of a future unless that medication works miracles. I hope that poor foster mother is compensated for her troubles somehow, and I really hope she doesn't take legal action against whatever agency landed her with the kid, because she certainly has grounds to.
-James
"How do you know if you're happy or sad without a mask? Or angry? Or ready for dessert?"
Carpal \'Tunnel
7,193 posts
Location: in the trees
7,193 posts
Location: in the trees
Posted:
when your young, your heads pissing with blood, you don't have a clue whats going on natural instinct kicks in, you gain strenght and will lash out and try to escape in ANY way you can so in one way i can see the kids point of view but i'm not psychotic............at least i don't think i am
when your young, your heads pissing with blood, you don't have a clue whats going on natural instinct kicks in, you gain strenght and will lash out and try to escape in ANY way you can so in one way i can see the kids point of view but i'm not psychotic............at least i don't think i am
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
Yeah. Kid's got issues.
Big issues.
Currently unsolvable ones. :-(
Yeah. Kid's got issues.
Big issues.
Currently unsolvable ones. :-(
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
Carpal \'Tunnel
7,193 posts
Location: in the trees
7,193 posts
Location: in the trees
Posted:
that is sad, in the UK they cut back on mental health so we have loads of nutters on the streets "community care" they call it but if someone is that dependant on psycho-active drugs then it's not his fault if he harms someone, not only will he not know or understand what he's doing, it will be a memory blank and it's down to local care to make suer he takes his med's and keeps him off the streets!
(awaits fall out from comments)
that is sad, in the UK they cut back on mental health so we have loads of nutters on the streets "community care" they call it
but if someone is that dependant on psycho-active drugs then it's not his fault if he harms someone, not only will he not know or understand what he's doing, it will be a memory blank and it's down to local care to make suer he takes his med's and keeps him off the streets!(awaits fall out from comments)
member
37 posts
37 posts
Posted:
sounds like the kid's going to grow up in a psych ward doped up on benzopines and anti-psychotics.
sounds like the kid's going to grow up in a psych ward doped up on benzopines and anti-psychotics.
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
Probably. Shame. But he's simply not safe in any other setting. It's a pickle, ain't it?
Probably. Shame. But he's simply not safe in any other setting. It's a pickle, ain't it?
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
BRONZE Member
Carpal \'Tunnel
5,814 posts
Location: Perth, Australia
Carpal \'Tunnel
5,814 posts
Location: Perth, Australia
Posted:
In a hunter gatherer society he would be out there running amok and either be an awesome hunter of remove himself from the gene pool. He probably has huge energy reserves and is bursting at the seams. Im sure people with little restraint and huge strength had a place but not in our world.
Our long history and what was selected for for so many years isnt always what we want now.
In a hunter gatherer society he would be out there running amok and either be an awesome hunter of remove himself from the gene pool. He probably has huge energy reserves and is bursting at the seams. Im sure people with little restraint and huge strength had a place but not in our world.
Our long history and what was selected for for so many years isnt always what we want now.
Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?
Im in a lonely battle with the world with a fish to match the chip on my shoulder. Gnu in Binnu in a cnu
SILVER Member
Mumma Hen
6,391 posts
Location: Brisbane, Australia
Mumma Hen
6,391 posts
Location: Brisbane, Australia
Posted:
oh how sad. He must be a very unhappy little guy
*sneds love rays to lil man*
oh how sad. He must be a very unhappy little guy
*sneds love rays to lil man*
TAJ "boat mummy." VALURA "yes sweetie you went on a boat, was daddy there with you?" TAJ "no, but monkey on boat" VALURA "well then sweetie, Daddy WAS there with you"
GOLD Member
Stream Entrant
2,829 posts
Location: Melbourne, Australia
Stream Entrant
2,829 posts
Location: Melbourne, Australia
Posted:
Hi Lightning
Antipsychotic drugs or not, I’m not sure the story supports your claim about the kid –You say “He's psychotic. It isn't his fault or the fault of bad parenting; he was born with a bad brain. And he's NEVER going to be OK.”
I would suggest bad parenting, and what is a “bad” brain?
I tend to think drugs are a band-aid to most of these problems.
Hi Lightning
Antipsychotic drugs or not, I’m not sure the story supports your claim about the kid –You say “He's psychotic. It isn't his fault or the fault of bad parenting; he was born with a bad brain. And he's NEVER going to be OK.”
I would suggest bad parenting, and what is a “bad” brain?
I tend to think drugs are a band-aid to most of these problems.
If we as members of the human race practice meditation, we can transcend our fear, despair, and forgetfulness. Meditation is not an escape. It is the courage to look at reality with mindfulness and concentration. Thich Nhat Hanh
SILVER Member
Pooh-Bah
1,848 posts
Location: Adelaide, SA, Australia
Pooh-Bah
1,848 posts
Location: Adelaide, SA, Australia
Posted:
Lightning's the doctor, not me, but i suspect what he means by a "bad" brain, is a brain that has some sort of chemical or physical abnormaity or imbalance.
A band-aid the drugs might be, but they have to suffice when there's nothing else to be had. We're not talking about ADHD, we're talking about psychosis.
Though parenting might have something to do with where a five-year-old learns language like that, I'm not going to go so far as to call it bad parenting either. I'm sure anyone trying to cope with a child like that would have to let the occasional swear word out, particularly if you've just been kicked in the groin for the 20th time that day.
I do hope someone can find something to help him function in at least a somewhat normal capacity. Maybe he won't be the most sucsessful person alive, but i hope at least he'll have a job and, more importantly, a couple of good friends one day.
Lightning's the doctor, not me, but i suspect what he means by a "bad" brain, is a brain that has some sort of chemical or physical abnormaity or imbalance.
A band-aid the drugs might be, but they have to suffice when there's nothing else to be had. We're not talking about ADHD, we're talking about psychosis.
Though parenting might have something to do with where a five-year-old learns language like that, I'm not going to go so far as to call it bad parenting either. I'm sure anyone trying to cope with a child like that would have to let the occasional swear word out, particularly if you've just been kicked in the groin for the 20th time that day.
I do hope someone can find something to help him function in at least a somewhat normal capacity. Maybe he won't be the most sucsessful person alive, but i hope at least he'll have a job and, more importantly, a couple of good friends one day.
"i am exotic, and must keep my arms down" - Rougie
"i don't understand what penises have to do with getting married" - Foxie
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
I think you have to think of this in terms of a bell curve. If a given species of bird has a given average wing length and width and you look at dead specimens of this bird found after a bad wind storm, you'll find that the dead individuals are often on the extremes of length-width ratio.
Similarly, suppose that, say, height is controlled by multiple genes. On average, a kid will get some mix of his parents genes and on average tall parents will have tall kids and short parents will have short kids, but occasionally an outlier happens and a 6'3" kid comes from two 5'2" parents. That's just how the genes sorted out.
Well behavior is largely genetic, in spite of how much we resist the idea and embrace our "nurture over nature" and "captaiin of my fate" philosophy. The proof is in the pudding: cats behave differently from dogs. Golden Retrievers behave differently from Pit Bulls.
So somewhere in there this kid got an "outlier" load of genes. I don't think this behavior would be adaptive in any human society. And that's an interesting point in and of itself because there are societies that are VASTLY different from ours that still cast out schizophrenics and autistics because they are unable to relate to others, regardless of the type of society and societal rules.
There are things that are ALWAYS maladaptive. These include heart defects, annular pancreas, wrong length/width ratio of the appendix, etc. The brain, being an organ, is hardly immune to these malformations. And the brain, being by far the most complex organ (60% of the genes in the human genome are expressed ONLY in the central nervous system), is probably more prone to genetic "goofs" than any other organ.
That's my take on it all. Kid got screwed. Plain and simple.
Written by: Gnor
In a hunter gatherer society he would be out there running amok and either be an awesome hunter of remove himself from the gene pool. He probably has huge energy reserves and is bursting at the seams.
I think you have to think of this in terms of a bell curve. If a given species of bird has a given average wing length and width and you look at dead specimens of this bird found after a bad wind storm, you'll find that the dead individuals are often on the extremes of length-width ratio.
Similarly, suppose that, say, height is controlled by multiple genes. On average, a kid will get some mix of his parents genes and on average tall parents will have tall kids and short parents will have short kids, but occasionally an outlier happens and a 6'3" kid comes from two 5'2" parents. That's just how the genes sorted out.
Well behavior is largely genetic, in spite of how much we resist the idea and embrace our "nurture over nature" and "captaiin of my fate" philosophy. The proof is in the pudding: cats behave differently from dogs. Golden Retrievers behave differently from Pit Bulls.
So somewhere in there this kid got an "outlier" load of genes. I don't think this behavior would be adaptive in any human society. And that's an interesting point in and of itself because there are societies that are VASTLY different from ours that still cast out schizophrenics and autistics because they are unable to relate to others, regardless of the type of society and societal rules.
There are things that are ALWAYS maladaptive. These include heart defects, annular pancreas, wrong length/width ratio of the appendix, etc. The brain, being an organ, is hardly immune to these malformations. And the brain, being by far the most complex organ (60% of the genes in the human genome are expressed ONLY in the central nervous system), is probably more prone to genetic "goofs" than any other organ.
That's my take on it all. Kid got screwed. Plain and simple.
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
Explain to me what sort of bad parenting leads to such behavior.
I mean I see BAD parenting. I mean TERRIBLE parenting. And the kids don't wind up like that.
Yes, the drugs are a band-aid. But they're all we have. How are you going to do therapy on a kid who's too busy screaming profanity and trying to bite you to listen?
Written by: Stone
I would suggest bad parenting, and what is a “bad” brain?
I tend to think drugs are a band-aid to most of these problems.
Explain to me what sort of bad parenting leads to such behavior.
I mean I see BAD parenting. I mean TERRIBLE parenting. And the kids don't wind up like that.
Yes, the drugs are a band-aid. But they're all we have. How are you going to do therapy on a kid who's too busy screaming profanity and trying to bite you to listen?
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
SILVER Member
15,417 posts
Location: South Wales
15,417 posts
Location: South Wales
Posted:
Is the child like that all the time?
Or did he just flip out on one?
Is the child like that all the time?
Or did he just flip out on one?
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
Well they did manage to temporarily calm him down with McDonald's...
Well they did manage to temporarily calm him down with McDonald's...
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
veteran
1,328 posts
Location: Bendigo, Vic, Australia
1,328 posts
Location: Bendigo, Vic, Australia
Posted:
hmm... Im surprised that didnt just hype him up more, with all the sugars, presevatives, etc in it
hmm... Im surprised that didnt just hype him up more, with all the sugars, presevatives, etc in it
GOLD Member
hehe, 'Member' huhuh
6,120 posts
Location: Behind you. With Jam
hehe, 'Member' huhuh
6,120 posts
Location: Behind you. With Jam
Posted:
But it'll be an ongoing cycle...
The sugars, preservatives will make him more hyper whilst the protein will calm him as it take alot of energy to digest. Then he'll have a sugar crash then get narky again till he gets another one...
(Sit him down and watch 'Super-Size Me'
But it'll be an ongoing cycle...
The sugars, preservatives will make him more hyper whilst the protein will calm him as it take alot of energy to digest. Then he'll have a sugar crash then get narky again till he gets another one...
(Sit him down and watch 'Super-Size Me'
"I used to want to change the world, now I just wanna leave the room with a little dignity..." - Lotus Weinstock
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
Even a charging tiger can be distracted with an enticing enough meal...
Even a charging tiger can be distracted with an enticing enough meal...
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
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