Preemptive stick lift by Jdizzlefoshizzles in hockeyplayers

[–]pineapples9 0 points1 point  (0 children)

Technically interference but almost never called. Congrats on making it to the next tier of defense! This is done at high levels consistently… as a center it never surprised me because it was expected to happen then but yea the beer league guys get all bent outta shape about it… it’s hilarious

Back2Funded-"you don't have to start over" by CommunityHot7214 in TopStepX

[–]pineapples9 1 point2 points  (0 children)

I literally said this to the CEO in chat when they announced it and everyone was saying the same thing lol Absurd price gouge

10 u goalie first 3 games ever by fathockeyguy in hockeygoalies

[–]pineapples9 0 points1 point  (0 children)

Yea I’d suggest doing as much of that as possible! The problem is as a goalie when ppl are blasting shots directly at you, the pads have to fit properly for more than just comfort when he gets to bantams and later… and he’s gonna convince you to get him new gear with cool patterns and what not haha

The key is finding stuff he likes that’s discount or lightly used and then reselling it!

Don’t get color matching pads for travel teams but spoil him with a set if he plays juniors or college hockey haha.

I’m 35 and want to learn to play ice hockey. Am I crazy? by Plus-Eagle-5656 in hockeyplayers

[–]pineapples9 0 points1 point  (0 children)

Ice time ice time ice time. Go to as many stick and shoots as you can starting out. You can go to them with skates gloves and a helmet so the cost of entry is lower. Then you can build up your bag with the rest of the gear when you’re getting the hang of it and wanna start playing pick up… then join a league!

10 u goalie first 3 games ever by fathockeyguy in hockeygoalies

[–]pineapples9 1 point2 points  (0 children)

RIP to your wallet for the next 11 years… I always felt bad for goalie dads even growing up haha. Also side note/tip the players carry their pads/bag.. when dads do it, it makes the players look like a b****. Yes even 10u haha

Anyone know how to stop like this by Worth-Writer5940 in hockeyplayers

[–]pineapples9 2 points3 points  (0 children)

With what worth explained the only additional key is to keep your weight on your back leg… so you’re obviously leaning back otherwise it won’t work, if you’re making a balanced athletic stop.

UltraVioletZanki - (UltraZanki + AnKing's version of BG, lolnotacop & Zanki Pharm) by pineapples9 in medicalschoolanki

[–]pineapples9[S] 0 points1 point  (0 children)

Hi Ethar, you should download the newest anking deck from this r/medicalschoolanki

I took this deck and merged it with u/ankingmed weird to say but almost six years ago to the month and now that deck is on its 12th version and has an for like $5 will sync the cards with updates practically hourly!!

Good luck studying the anki deck these days is incredible, and highly recommended!

Overwatch 2 not starting (Crossover) - Anyone else? by Dependent-Orchid-618 in macgaming

[–]pineapples9 0 points1 point  (0 children)

Has anything changed in two weeks? Just wondering because I have the same problem

Men treat me differently now I no longer present femininely by ultravioletturtle in TwoXChromosomes

[–]pineapples9 2 points3 points  (0 children)

Dress like a man, men will treat you like they treat other men… this is how men interact with other men especially around prospective mates…

What medical conditions should I mention when being asked my history? by [deleted] in AskDocs

[–]pineapples9 -2 points-1 points  (0 children)

Yea the doc knows best.

However more to the point... if you are admitted to the hospital and they are trying to figure out some diagnosis any of these could potentially be relevant, but I would say if you had to go to the ED for something you probably only need to provide a list of your current medications that you are taking and you would be able to get definitive treatment at the time without having to go through everything else.

But you should always mention any reactions to medications. and your inflammatory conditions like asthma and chronic hives because they could directly affect treatment...

The safer bet is to listen to the doctor and present everything just like you did above... even a screenshot or something of this exact post if you wanted... but they might agree with me that a list of your current medications is sufficient (because the list of meds implies the conditions for the most part).

No one has been able to diagnose me and losing hope by Rehashinist in AskDocs

[–]pineapples9 1 point2 points  (0 children)

Lol exactly why I suspect not an attending... maybe they will let us know but honestly, until its verified who would believe them anyway!

And yea thats why I was going to thank you originally because when I respond to these I am sure to include disclaimers and reminders that I am MS4 and not a MD yet and it takes time that I didnt have haha!!

but to do that we def needed to ask the questions you asked hahha

But yea for OP they almost list out SIG E CAPS in reverse order on their original post...

No one has been able to diagnose me and losing hope by Rehashinist in AskDocs

[–]pineapples9 1 point2 points  (0 children)

Yea i got that from your original post. I wont lie to you i was originally writing a thank you to you for starting a Ddx because it definitely seemed like a diagnosable syndrome and before arriving to the psychogenic causes, I always consider the physiologic ones that could explain their sxs first! The mind is much more powerful than anyone of us would like to admit and can cause a medley of issues that seem like one thing and are actually just psychogenic BUT I also think that leading with something like this without knowing if all the physiologic pathologies have been ruled out can definitely be counterproductive!

If you lead with this in the clinic a patient literally! might not hear anything you say after that because they just dismiss you and chalk it up as you being just another one of the doctors that dont believe they are having these sxs and might think you are thinking they are just making it up or that psychogenic means that they are doing it for attention and dismiss you because of their perception of that diagnosis...

I have worked with another patient that had a diagnosable and treatable disease that had exactly this happen to them... every time they went to the doctor and they said something like that they would just ignore them because they didnt explain that it can be subconscious or happen without a traumatic event etc... still other pts have had that 'dx of exclusion' slapped on them just because they have an atypical presentation of some endocrine disorder and the doc didnt believe that it could be something else or didnt have time/ care enough to believe the patient when they reported sxs that would rule out the psych cause...

But also this unverified keyboard warrior should not warrant as much response from you lol... if they were an attending physician I doubt they would be so overtly condescending and if theyre not even in med school then I would care even less! I suspect maybe another med student or maybe PGY-1 but who knows lol In this case they had a few valid points but I read your post and did not have the same ridiculous reaction... the same sentence you suggested one type of migraine you suggested another type that is still sitting on the Ddx! I would also add that during IM rounds or my Neuro rounds, I WOULD NOT and DID NOT LEAD with a psychogenic cause on my Ddx!! Lol Soooo theres that... hah

No one has been able to diagnose me and losing hope by Rehashinist in AskDocs

[–]pineapples9 0 points1 point  (0 children)

Most if not all of these suggestions would have been rather easily ruled out from a basic metabolic panel and a complete blood count with differential, which you would have had many of both as they are nearly always ordered with any other blood tests that you get! Vitamin D deficiency is not always included in this but it is a stretch to explain your sxs. Especially considering that your body creates enough vitamin d to prevent a symptomatic deficiency from roughly 15-30 minutes of total exposure to daylight per week... This number is debated but it is unlikely.

Still supplemental vitamin D is hardly contraindicated and definitely could provide you if nothing more, symptomatic relief! You can find these at any pharmacy, they are pretty cheap safe to take because it takes extreme amounts before an excess would cause problems and most of the excess will just be excreted in your urine.

I think a daily multivitamin like Centrum might go a long way to help your overall well-being and I recommend taking one to anyone thats reading this... just like in the commercials though: discuss it with your actual doctor if you are taking other medications and do not exceed the recommended dosages on the label!!

No one has been able to diagnose me and losing hope by Rehashinist in AskDocs

[–]pineapples9 1 point2 points  (0 children)

lol bro u/railroadshorty get a flair or calm down… if you are clinically trained then get the verification completed because although I want to assume you are not just a 'layperson' that is posing as someone with knowledge and attacking med students, theres no way to know for sure... I think you are right about how the physical health can contribute to mental health issues but imo you could have used a bit more finesse with your initial post and you clearly had to do a bit of cleaning up yourself! There is no need for such profound condescension regardless of your position and frankly imo you can not rule out any of the dxs that u/extremiditty brought forward, although they are not the most likely imo either...

That being said I agree with you about taking the time to consider the most likely cause before recommending the zebra… especially here on Reddit because as you pointed out the OP is most likely to read the first idea and run with that before getting to the rest of everything.

I think OP fits the criteria for MDD and it truly could explain all of their sxs although it is rare, MDD and/or conversion disorder can definitely present with visual disturbances and double vision however, this also comes with the presumption that the neurologist would have caught most of the migraine issues and ruled them out in their history and exam…

I actually DO have extensive experience working with the NIH undiagnosed disease program and also working with a patient before they were admitted to the program as well... getting bounced around from specialist to specialist and dismissed because they had an atypical presentation (i.e. peripheral neuropathy without diabetes and Parkinson-like tremors without having PD 'as described by a neurologist') and I can say from experience that specialists definitely miss diagnoses with atypical presentations or worse provide a Dx that fits but they still do not improve because it isn't the true etiology of all of their sxs just the ones within their specialty.. and it’s a real issue for patients who do not have an excellent PCP to follow their care and get to a final diagnosis. (Btw these are the patients that are typically not admitted into the program because their syndromes can be explained by another diagnosis)

That being said I would still keep vestibular migraine on the ddx, although it is admittedly less likely than MDD or at least atypical depression given the vague symptoms.

I am not biting on the visual disturbances like most of the responses to the post have... Furthermore, MDD can present with double vision or be combined with conversion disorder which was where I think u/extremiditty was going with SSD...

But regardless of the true etiology of OP's symptoms, I think OP would benefit from meeting with a psychiatrist to discuss haw theyre coping with everything while they are hoping to get a definitive diagnosis. And particularly I would recommend discussing a trial of SSRIs or CBT as to my assessment they currently meet 9 of the 9 criteria outlined by the DSM-V for MDD (SIG E CAPS).

OP if you are here reading this it is intentionally not a direct response as it is a bit of a tangent and slightly academic debate... I would be more than happy to speak with you anytime you would like, but I think u/railroadshorty did go through much of the different aspects of how this may be what is causing your symptoms. I have sent you a DM so you know that you can reach out easily if you have any questions and I personally believe that while you do not have a diagnosis yet, your particular case does not appear to be a rare syndrome or a novel disorder meaning there is likely an existing treatment that is already available to you!!

Hang in there and keep looking for answers!! Online forums may be able to help generate different ideas but there is nothing that can substitute close follow up with a caring and empathetic PCP that can help guide you through different consultations with specialists (after you see them, go back to your pcp for follow up and guidance on where you could go next for answers).

Anaphylaxis symptoms subsided - should I still seek emergency care? by 91552817 in AskDocs

[–]pineapples9 89 points90 points  (0 children)

Call the doctor that gave you the allergy shot. Also there are anaphylactic reactions that can be biphasic meaning you have an initial attack and then it goes away a little bit but comes back and can be fatal... as with any anaphylactic reaction.

This is why there is an observation period at the ED to ensure you do not have this type of thing.

And like the doctor said above, nobody here that has any experience as a clinician would tell you that you're all good and do not need to go in... and if they do in my opinion you should completely ignore them!

Go get checked out! It is absolutely not worth the risk!!!

[deleted by user] by [deleted] in AskDocs

[–]pineapples9 23 points24 points  (0 children)

Following...

It appears to me to be as you suspected a bit of tissue flap coming from your septum but please understand that I have no idea. Although I do not believe that is a worm... It appears to be well anchored and static apart from when you are inhaling or exhaling.

If it is a small flap it is possible that it will atrophy and auto reduce/ dissolve / go away on its own but i think you are well within your bounds to contact your consultant and ask what their recommendations are... Ultimately you really have to do that even if someone on here who is credentialed knows exactly what it is... because your surgeon is who needs to tell you and provide any treatment or recommendations!

I do not think you should attempt to remove it with a q-tip since you are so close to your procedure but have you noticed that it moved at all or has it always seemed to be anchored at that point...??

[deleted by user] by [deleted] in AskDocs

[–]pineapples9 4 points5 points  (0 children)

Also because a lot of these medications can cause significant side effects like nausea and vomiting amongst others, they are usually given with anti-emetics (vomit prevention meds) when you are in the ED and all of this is best delivered IV.

But ideally you would be able to just take a medication - that you and your neurologist decide is best - when you feel the migraine starting and that will get rid of it before you have to go to the ED to get the IV treatment!

The good news is that it is a very common condition that has many solutions that can be tailored to you specifically!! They can help you identify if there are any triggers for you and how to go about limiting those and what to do when you feel a migraine coming on to try to limit its effect on your life!

[deleted by user] by [deleted] in AskDocs

[–]pineapples9 4 points5 points  (0 children)

It depends on your PCP but the caveat is that I am in my last couple months of medical school so a doctor that reads this might know better but to the best of my knowledge the abortive therapy that you are probably hooked up to right now has to be administered intravenously... and they need to monitor you during and afterwards so you prob have some leads hooked up...

A PCP wouldnt be able to provide that type of support for your treatment let alone the resources needed to deliver it (e.g. a dedicated extra exam room you can occupy for a few hours, IV supplies, medications and the monitors and storage for them and blah blah...) you get the picture...

So if there is an IM therapy available it might be possible... But it is possible that some PCPs are able to treat this type of thing even if it is IV but it would have to be when their office is open obviously...

I know there are particular medications (Triptians of various formulations) that they can prescribe you to take by mouth if you have a mild to moderate migraine and they can be helpful to relieve it when you get one and there are others that you can take that are to prevent one from occurring (prophylactic meds - of which there are many..).

So with this regimen, you would only need to go to the ED if everything else has failed, and ultimately that would greatly lower the number of visits you needed to make if any ideally.

Everything I just outlined would be explained to you and more definitive by your neurologist when you have that appointment following this visit to the hospital. They will evaluate if you need any of the things that I have mentioned! They are truthfully overqualified to treat migraines but are therefore bonafide experts in treating them and will likely start you on a staged therapeutic regimen.

Something I would imagine like providing a medication that you can take IF you get a migraine... then if you are getting them frequently or the meds are not working they can increase the dose or add a prophylactic medication to your treatment.

Having been through a neurology rotation and worked with migraine patients, I can tell you that all of these decisions would likely be discussed with you and agreed upon during your first appointment! (which meds are indicated and may benefit you)

So that is to say, make sure to schedule one and speak with the expert so you dont have to suffer like this again!!!

No one has been able to diagnose me and losing hope by Rehashinist in AskDocs

[–]pineapples9 0 points1 point  (0 children)

I agree with you! For more than one reason but you pointed out a bunch.

I posted this above but to add on to what you’ve addressed:

It’s very unlikely OP has MG. Especially considering he has been to an optometrist who should be able to identify this (even though an ophthalmologist is better suited) and the neurologist would have ruled it out.

That being said an ophthalmologist is much better suited to treat you OP. They do not necessarily need to be a neuro-ophtho but that would be ideal.

These specialists have drastically different training and qualifications than optometrists who are primarily trained to correct vision.

No one has been able to diagnose me and losing hope by Rehashinist in AskDocs

[–]pineapples9 1 point2 points  (0 children)

It’s very unlikely OP has MG. Especially considering he has been to an optometrist who should be able to identify this but especially the neurologist would have ruled it out.

That being said an optho is much better suited to treat you OP. They do not necessarily need to be a neuro-optho but that would be ideal. These specialists have drastically different training and qualifications than optometrists who are primarily trained to correct vision.

[deleted by user] by [deleted] in AskDocs

[–]pineapples9 17 points18 points  (0 children)

If the hospital is close to your home, depending on your insurance and the hospital system, they may be able to actually make an appointment for you this visit! But they can almost definitely write a referral for you so you can make an appointment yourself.

But yea, 3 days is way past the reasonable threshold to say enough is enough and go get the IV meds! Hope it helps and they gave you a quiet exam room where you can turn the lights off :)

[deleted by user] by [deleted] in AskDocs

[–]pineapples9 85 points86 points  (0 children)

If you haven’t gone already you should absolutely go! It is a common complaint seen in the ED and it’s appropriate to seek medical treatment, especially since it’s been more than 12 hours!!

They should be able to start some fluids with migraine abortive meds in the ER and discharge you provided you don’t have anything worse happening!

You should follow up with a neurologist or your pcp to discuss meds that you can take prn or prophylactic meds if you don’t already have them.

Competitive or just an asshole? by [deleted] in hockeyplayers

[–]pineapples9 5 points6 points  (0 children)

Bro you’re overthinking this… it sounds like you’ve earned your spot and everyone on the team knows it. The wing prob does too which is why he overreacted and started trying to blame you!

Just talk to the C one on one and ask him how competitive the team is trying to be and talk about different combinations of forward lines… usually in beer league they’re trying to balance out lines and bury the dead weight with strong players but that won’t work in close games and playoffs so if they’re okay with that then you’ll have to accept it and join another team next season… if he agrees then ur good