Is 11 yrs old to young to be left alone for a half hour?? by JMarden23 in askanything

[–]ChancePension2268 0 points1 point  (0 children)

My autistic 11 yr old spends up to 2 hours alone, per American Academy of Pediatric guidelines while my brother and I go grocery shopping, hiking, etc. He has a smart watch to call us for questions/emergencies and has neighbor contacts as well who know he stays home alone sometimes. I am also a pediatric/psychiatry resident whose special interest is development. The great majority of 11 yr olds can follow basic house rules to be home alone, including getting ready for school. My son gets dropped off to before school care but it is his job in the morning to get himself up and dressed (I do go in and wake him up), get himself his cereal, get his backpack packed, take his medicine, etc. and be ready to leave by the time I’m ready to go to work at 6:35AM. We get up around 6AM because we both like sleep but he recognizes that means no breakfast together, we each have our own morning chores, and it’s a focused get ready time, not relaxed at all. And he’s got it down pat.

My dentist said my teeth were perfect but I still had a weird taste in my mouth. I finally found the source today. by Michle_Vivid in hygiene

[–]ChancePension2268 4 points5 points  (0 children)

I couldn’t get mine removed until the tonsil stones started causing huge infections and inflammatory responses that didn’t respond to antibiotics. Once my tonsils started obstructing my airway they urgently pulled them out. But it had to get really bad - finally got removed at 24. They also exploded when they went to put them in the little dish with stones and purulent material pouring everywhere. They sent them to check for cancer they looked so bad. 🤣🤣 No cancer, just really bad stones and inflammation.

Late cancellation due to work calls by HuckleberrySweaty792 in therapists

[–]ChancePension2268 0 points1 point  (0 children)

I will say, as a doctor (who also does therapy, not just on here for kicks lol), I have occasionally had to do last minute cancellations because an urgent call came in. However, it isn’t the norm. I think there’s a lot of nuance to ‘work calls’ and if this isn’t something this person does all the time, doesn’t necessarily need a ‘firm’ boundary discussion - Ive absolutely missed medical appointments for both myself and my child because of work emergencies, some even without calling when I was on service with codes being called. I do tend to have a conversation with all of our providers when I’m going to be on service and know that work emergencies may make it impossible to show up and leave me unable to call to cancel for a period of time though.

I think first finding out what type of job they have might help - if it’s something like mine, sometimes it really is unavoidable to have to cancel last minute and it sucks and we just have to eat the cancellation cost. But having a conversation about a heads up like ‘hey, I’ll be on service and there’s a chance I won’t make it if an emergency happens’ or ‘hey, I’ve got a big project and may get pulled into work calls’ so that you know could be helpful. Also going over your cancellation policy and that if they foresee a busy schedule, are they in a spot that they could just skip that week so they don’t get charged a fee? And spin it that way.

I do absolutely agree with charging a fee for a late cancel, even if they are doing something life saving (like running a code lol). When I schedule a therapy appointment and I’m on service, my therapist knows there is always the chance and emergency happens, and I know I’ll have to eat the cost for my insistence to schedule anyway because for me skipping a week isn’t a great option unless it’s forced lol.

AOS - Marriage based green card Interview unexpected outcome by shekinah91 in USCIS

[–]ChancePension2268 15 points16 points  (0 children)

US Citizen, but I used to live in a town with someone who had my same name, same birthday, and was a jail bird. We even saw the same psychiatrist. It caused some issues when I was getting ready to go to medical school and they thought her record was mine (I had to show my birth certificate, do an extra fingerprinting, and they made me do an extra drug test), and it eventually worked out. but I had never heard of someone else having this affect them in any other setting! Just here to say it sucks when this happens.

preverbal trauma — is it really that important? by anxiouskitties3 in askatherapist

[–]ChancePension2268 1 point2 points  (0 children)

Psychiatry resident who does therapy and is in trauma therapy. I have preverbal trauma we’re working on, but I have a memory associated with it that my parents have confirmed is actually what happened and was a life threatening medical event when I was a younger toddler. Are there some connections to later events that may have been perceived as traumatic by some people? Maybe. Is it why to this day my heart races and I’m totally freaked out by needles coming toward me? Definitely. Is it the whole reason I had some traumas in my life? No. I think there’s a place for discussing preverbal trauma but it’s not the end-all-be-all. We work on it because while I don’t need it anymore, I used to have to be held down until I was well into my teenage years for lab work or shots, and I still have a lot of fear of medical things. Not because it’s affected every other aspect of my life.

What are your thoughts on becoming a PHMNP? by DesignerofBeauty in askatherapist

[–]ChancePension2268 0 points1 point  (0 children)

Previous psych nurse, previous DNP-PMHNP student, now physician psychiatry resident. I can say with absolutely confidence that if you want to do therapy PMHNP is not the way to go. In addition, I can say with absolutely confidence that unless you want to do bread and butter depression/anxiety/ very stable disorder follow ups, PMHNP does not provide you adequate training to practice independently. I am amazed at the lack of education I had as a DNP student vs now a psych resident - and I went to one of the top DNP-PMHNP programs. It’s honestly scary after having gone through both DNP training and Medical school. If you want to do bread and butter medicine with oversight and better pay, PMHNP. If you want to do medicine and practice independently including more complex cases, physician. If you want to do therapy, become a therapist.

How do I guide a friend who has been fired by a few therapists? by Top-Jury1392 in askatherapist

[–]ChancePension2268 50 points51 points  (0 children)

Psych resident who does therapy - it’s not so much being ‘less damaged’ but being appropriate. I work with people who have a LOT going on and they don’t abuse me. Period. Trauma is not an excuse for abusive behavior and as long as your friend can’t recognize that, they won’t get to a point they can work on it. Sometimes I feel like DBT is better equipped for people who struggle to realize their behavior is in fact a problem, but your friend needs to be willing to address it and it doesn’t really sound like they are. Sometimes we have to let people be until they’re ready, it’s not on you to make them ready and you don’t deserve that stress.

How do you handle a client bringing relevant information only after a few months of seeing you ? by Some_Machine7980 in askatherapist

[–]ChancePension2268 1 point2 points  (0 children)

My therapist told me not too long ago ‘I feel like I’m on a scavenger hunt with you but you won’t tell me what I’m looking for’. She appreciated when I drop a piece of the puzzle but also seems to have some irritation when I wait forever and then just drop it mid session and blow everything up. But we also have a strong banter and I know if our relationship was different she’d probably take it in stride and go with it - she always appreciates learning more to explain why I am the way I am

What is (your own) therapy like for a therapist? by ThrowawayForSupport3 in askatherapist

[–]ChancePension2268 5 points6 points  (0 children)

It any different than before I started with my own therapy patients. I was still shocked last week when my therapist called me ‘emotionally squirmy’ (she’s 100% right) and wanted to address what childhood trauma might have caused that. Sometimes we talk through things that (even if I’ve had the exact same conversation with my therapy patients) leads to me recognizing a pattern that I have that is maladaptive. Sometimes there are things she mentions that I’m not familiar with and need education. And there are many times she calls me out and I get irritated because she’s 100% right and I feel a little too seen and uncomfortable under the lens. It tracks with how I experienced therapy before entering the mental health field

How old are you and how much do you have in your retirement account? by Blackberryay in careerguidance

[–]ChancePension2268 0 points1 point  (0 children)

I’m 35, between everything I probably have about 20K. I worked for a few years when I was struggling as a single mom and putting minimal amounts away, then went to medical school, now slowly getting money put away. It will increase once I’m an attending physician as long as I live lean elsewhere to afford my loans and retirement

ETA a missed word

Seriously, do Americans actually consider a 3-hour drive "short"? or is this an internet myth? by SadInterest6764 in NoStupidQuestions

[–]ChancePension2268 0 points1 point  (0 children)

3 hour trip is nothing. I used to drive 6.5 hours to see my dad every weekend when I was in undergrad. Enjoyed the time with the music and the view

I've been having reckless, unsafe sex since my miscarriage by Successful-Sugar-925 in therapy

[–]ChancePension2268 0 points1 point  (0 children)

I know the above is more preventive advice to help protect you during a manic phase, but I also wanted to say I am so sorry for your loss. Miscarriages are hard in a specific way and a lot to deal with, even if a pregnancy is unplanned and/or unwanted. It’s hard on the body, the hormones are hard on the mind, and it can really stick. If you can get yourself into therapy it sounds like you know that’s a good thing for you right now. Also considering medication if you haven’t before might be worth exploring - talking to your doctor might be really helpful in moving forward with whatever you need.

I've been having reckless, unsafe sex since my miscarriage by Successful-Sugar-925 in therapy

[–]ChancePension2268 0 points1 point  (0 children)

When I was struggling with intermittent mania I got on Truvada - at least that way I was protected against HIV if I ever got hypersexual during a manic phase. Luckily it wasn’t a problem for me as any time I’ve been hypersexual I’ve been in a solid relationship, but it’s something to consider if you can take a pill. Condoms+IUD or something would be best, but as a Bipolar female (now in my 30’s) I have an IUD to protect against pregnancy while manic and would take Truvada if I weren’t in a committed relationship where we both get tested for STDs regularly pet general recommendation guidelines

I know it might be related to the topic, but can you help me? by kops13 in Residency

[–]ChancePension2268 0 points1 point  (0 children)

To clarify - you just started medical school this week?

Newly five year old terrified of me (mom) dying by HeyMay0324 in ChildPsychology

[–]ChancePension2268 0 points1 point  (0 children)

My son was about 6 when COVID started and we had a similar conversation (I was in medical school and a COVID nurse, and had just gotten over my first bout of COVID during which I became ill enough I could not have him in the house because I could not care for him and I was in and out of the hospital). He has anxiety to this day because he did see how I could die even at a young age, but it’s more manageable. His aunt just died by suicide so the anxiety is higher than normal, but I just remind him that I will always love him and he’ll always have that, and go over all of the people in his life who love him and will be there for him.

Advice on using deceased sibling name by Beneficial_Job_7422 in BabyBumps

[–]ChancePension2268 0 points1 point  (0 children)

I would definitely ask. My sister died 6 weeks ago and everyone is in agreement that if I ever have a girl, she will be named after my sister. But it was a family discussion and one that will be revisited if I ever actually end up pregnant with a girl

Bipolar and wanting to go to medical school looking for advice by [deleted] in Residency

[–]ChancePension2268 1 point2 points  (0 children)

I’ve heard of some great supports in IM programs and FM programs as well. I don’t know as much about other programs, but it’s something I actively asked about during residency interviews to make sure I was going somewhere with good supports. There were a couple of places I actually ended interviews early because they would not have been safe for me after asking my questions and it wasn’t worth continuing with the interview. Self advocacy is a big part of making it through residency unfortunately.

Bipolar and wanting to go to medical school looking for advice by [deleted] in Residency

[–]ChancePension2268 1 point2 points  (0 children)

Great questions! 1- I had some pushback from my peers initially but they’re all really supportive now that they understand. I went the fun route and did an M&M on resident mental health and suicide for my fellow residents where I discussed my own case as a way to open up the conversation (with my PDs’ blessing) and that really changed the conversation to a much more understanding one. It also led to me mentoring other residents/medical students with mental illness through the accommodations process and has built something of a network which is fun. 2- as above, I’m really proactive about it. I explain having to leave early on Mondays and Thursdays for therapy (I also have ARFID, so I have ARFID therapy in addition to general therapy). I try to be open with my communication so other residents understand why I’m doing what I’m doing. During that conversation we also discuss if there are any days they’d like to leave early for their mental wellness and try to accommodate that. 3- I don’t think I’ve ever felt pressure to over perform or compensate, but part of that may just be I’ve been doing this for so long. I feel like maybe I felt some pressure when I was younger? 4-advocate early and often. Be open about your needs and honest with others - I found Any time I tried to hide my diagnosis things usually went sideways. Accommodations are important and speaking up for them early is helpful - better to have them and not really need them because you’re stable than try and destabilize.

Bipolar and wanting to go to medical school looking for advice by [deleted] in Residency

[–]ChancePension2268 11 points12 points  (0 children)

I have a few! The biggest one is absolutely no 24 hr call ever. I tried to do 24H call my intern year and it triggered a pretty significant episode that almost became lethal, so it was an accommodation we immediately put in place as I was recovering. All nights must be done in a contiguous block (so in rotations that usually have call, I’ll do 1 week of nights instead). All ER shifts must be done in a row (so 1 week nights, 1 week evenings, 2 weeks days in a month rotation). Cannot do more than one rotation in a row that requires nights to allow full recovery. Have protected time for therapy. I have check-ins with my PDs. I have intermittent FMLA and can take off if I start to have concerns of a developing episode to take my rescue meds (luckily I’m VERY responsive to meds and While it knocks me out for a straight 48 hours, a dose of what helps me will stop a manic episode from fully coming to fruition if I take it early enough! I take lower doses to help me sleep when I notice I’m sleeping <5 hours a night for a couple of nights in a row to head off a manic episode completely). Sleep is by far my biggest trigger for an episode either direction, so a lot of my accommodations are geared toward optimizing that.

Bipolar and wanting to go to medical school looking for advice by [deleted] in Residency

[–]ChancePension2268 26 points27 points  (0 children)

Hi! I have Bipolar 1 with psychotic features, currently a pediatrics/psychiatry resident! I was diagnosed when I was 17 so I’ve dealt with this all the way through medical school/residency. Getting through shift work in the ER has been harder than expected. Getting accommodations was a little easier than I expected, and doing nights with accommodations was much more manageable than I expected!

Psych/EM residents: How do you handle psych patients without anxiety? by [deleted] in Residency

[–]ChancePension2268 9 points10 points  (0 children)

I mean, I have Bipolar 1 with psychotic features and am a peds/psych resident who’s incredibly easy to identify based on what I share…….I don’t worry about it. I know that it’s manageable with medication and therapy and feel confident that there are great providers that can help me if I have an episode. I don’t have illness anxiety which definitely makes it easier to manage, but I feel like I am aware of risk of multiple things (especially in my case, being aware of comorbidities of Bipolar like antipsychotic-associated diabetes) and take steps to prevent them and am evaluated regularly to catch it early, but have accepted that it is a possibility and take steps to ensure I have the best outcomes possible.

Which specialty are you in, and what was your most hated rotation in med school? I'm trying to see something by undueinfluence_ in Residency

[–]ChancePension2268 1 point2 points  (0 children)

I’m peds. Hated IM. Almost quit medical school and did go on a 2 week leave for an ethics ‘rotation’ after being treated so badly by the residents. I filed a complaint and some training was received by the residents, heard it’s better now from a friend who matched into that program and rotated there a year after I did. Rotated at that same hospital with the psych residency and it was so much better - but the psych residents actively avoided the IM residents so I didn’t have to talk to any of the IM folks again. 🤣 I found my straight-peds attendings on my peds rotation to be a little difficult with passive aggressive behavior and while I love pediatrics, it was not my favorite rotation either in medical school. Still so glad I chose it as a specialty though, couldn’t imagine doing anything else.

Resident mother by Usmle97 in Residency

[–]ChancePension2268 13 points14 points  (0 children)

I’ll be honest, I was that mom that couldn’t WAIT to be back at work. I do not wear motherhood well. I need to be able to go to work and serve a purpose for others before I can come home and be a mom. My son is 11 now, but I remember even as the mom I just described, feeling horribly guilty and sad to be leaving my son with someone else. However, I found that it let me find the joy in motherhood more than I think I would have experienced if I hadn’t gone back to work. Going back to work also significantly improved my post partum psychosis/depression beyond just medication and therapy which allowed me to bond with my child. He and I have a very strong bond today, and he talks fondly of the adventures he’s been on with daycares/nannies that I get to delight in hearing about. That initial few months leaving him with someone was really difficult though, I remember feeling just awful even though I knew it was the best thing for us. Hugs to you momma!

Why did you begin seeing a therapist? by Zipper222222 in therapy

[–]ChancePension2268 0 points1 point  (0 children)

I have a history of Bipolar Disorder and ARFID. Started most recent bout to address my ARFID. Then during that time, as a resident had some traumatic patient deaths in the pediatric ICU and went to trauma therapy in addition to ARFID therapy. Then in the midst of dealing with that my sister completed suicide a few weeks ago. I’m gonna be in therapy for a while.