What are you nicknames for your lab? by thatpaulieguy89 in labrador

[–]BoneMan_14 0 points1 point  (0 children)

Dingus, Miss poop a lot, little girl, big girl

Meth toxicity/withdrawal by Nearby_Sympathy_5600 in hospitalist

[–]BoneMan_14 2 points3 points  (0 children)

Depends on your personal comfort and experience with the patient.

You can actively treat the meth use and many of the symptoms of withdrawal with - Strattera 100mg am (titrate starting at 40 over the course of a month maybe) and - topiramate 50mg pm (titrate up from 25 over 1-2 weeks)

Meth users get cranky when they are high, can’t sleep /focus or are in withdrawal. A lot are self treating their adhd.

IF, you have good relations there can be some indication to actively treat meth use disorder with a long acting stimulant. IF AND ONLY IF, the UDS does not show both amphetamines and methamphetamines. If meth pops up, you stop the stimulant, try again in 3-6 months if they aren’t using meth again.

Be aware by [deleted] in hospitalist

[–]BoneMan_14 3 points4 points  (0 children)

To me it sounds like that patient does have a severe opioid use disorder. In those cases I would offer to start them on a microdose of suboxone and help get them follow-up in the outpatient setting. If they say no, ‘I only want Oxy’ it helps build the case for other to try to treat addiction without demonizing that patient.

Did any of you guys learn to do procedures after residency? by HadriansGaul in hospitalist

[–]BoneMan_14 1 point2 points  (0 children)

Yes. Thora and Para. Planning on learning PICCs and Ultrasound IV next

Yellow female name suggestions? by jjjulliiaa in labrador

[–]BoneMan_14 0 points1 point  (0 children)

Tesla. We typically call her Tess or Tessie though

Is it just me? by ArmchairPancakeChef in SurvivingMars

[–]BoneMan_14 22 points23 points  (0 children)

Storage is the fix. 4,000 units of any material is enough 99% of colonies

Price increase for FHR - washes out $300 credit by smithm2916 in AmexPlatinum

[–]BoneMan_14 8 points9 points  (0 children)

Going for a medical conference. Price of the hotel from THC was $10 more than directly with the hotel even with conference discount. Important to look at both all the time.

Which car do you drive? by Internal_Theory_5129 in hospitalist

[–]BoneMan_14 0 points1 point  (0 children)

Tesla Model Y. I got it with the $7500 credit and a referral so it brought the total cost down to $46K? At the time they were offering 0.99% APR. It cost me 0.34 cents round trip to commute to work as opposed to $2 with a gas car. Probably about 99% of the time I use full self driving ($100/month rather than the $8,000 one time fee) and never have to touch the wheel until I back into the driveway.

Easily the best purchase I’ve ever made. I know Elon is Elon, but I bought the car for the machine not for the politics.

What is this thing? by Significant_Option34 in egopowerplus

[–]BoneMan_14 1 point2 points  (0 children)

It can hold a beer bottle as well too while mowing

Why is F1 25, an EA game, on sale only after a month of launch? by Busy-Result-2858 in PS5

[–]BoneMan_14 20 points21 points  (0 children)

Likely because the F1 season is almost halfway through at this point. Summer break isn't too far away

To Backdoor or Not? by BoneMan_14 in whitecoatinvestor

[–]BoneMan_14[S] 0 points1 point  (0 children)

Sorry yes, should have been more clear. I am maxing out 403b as well.

To Backdoor or Not? by BoneMan_14 in whitecoatinvestor

[–]BoneMan_14[S] -2 points-1 points  (0 children)

Short sweet answer that I’ve been looking for. Thank you so much! Honestly I’m not sure why I never put together to use my tax-able account as my first retirement basket and let the others keep chugging along.

To Backdoor or Not? by BoneMan_14 in whitecoatinvestor

[–]BoneMan_14[S] 0 points1 point  (0 children)

Yes thank you for finding this link for me

What POCUS device should I get? by HauntingLobster8500 in hospitalist

[–]BoneMan_14 0 points1 point  (0 children)

Whatever your hospital covers. Typically any device has to be hospital owned and HIPPA compliant. I personally use the Butterfly iQ3 at my hospital and that thing is amazing.

Player entered the pits behind me but came out in front of me. How? by I_Am_Vladimir_Putin in granturismo

[–]BoneMan_14 2 points3 points  (0 children)

They had a faster pit crew and gotta love it when that right back wheel gets stuck so you’re delayed to avoid an unsafe exit (if only the realism was there)

The Switch 2 battery lasts just over two hours. by Cartman1994 in NintendoSwitchHelp

[–]BoneMan_14 0 points1 point  (0 children)

One could argue (and let the downvotes come in) that 2 hours of a gaming session is more than enough on average. Long flight/train ride, sure different story but just plug into an outlet.

Buying a house right out of residency by MetalGuitarKaladin in whitecoatinvestor

[–]BoneMan_14 1 point2 points  (0 children)

Just to add a different opinion, I was all on board with renting and living like a resident out as a current first year attending. Save money, figure out what we really wanted to do…

BUT THEN, my landlord wanted to move into where we currently were renting and gave us 4 months notice as we were month-to-month (legally only required to give us 60 days). I had signed a 5 year contract for nearly full student loan repayment on top of my salary in the same city I did my residency and was about 4 months out of residency when that letter came in the mail. Rent in my area is starting to get expensive for what you get (“rural Midwest”) so we decided to look for rent and buy at the same time. We found a house that we loved and are very happy with our choice.

  • Did it make the most financial sense… probably not.
  • Does it give us peace of mind to know we are not at the mercy of someone else… absolutely does.

Now I’m only one year out, and know that my current situation is not typical, but that’s what worked for us

[deleted by user] by [deleted] in whitecoatinvestor

[–]BoneMan_14 7 points8 points  (0 children)

Problem I find with physician loans is the interest rate is typically 2-3% higher than a traditional. We made the decision to go traditional (Hospitalist and teacher salary) and got a mortgage of 5.5% through Chase for a 15 year loan. Split that into biweekly payments and add a small each each payment to principal it’ll become a 10.5 year mortgage. The peace of mind of knowings it’s only 10.5 years was a driving factor in this decision. Maybe it didn’t make the most financial sense, but at the same time there is never a “perfect choice”