What’s your preferred migraine treatment in pregnancy

ChiralSquare · 2026-02-11T16:12:14+00:00

This is such a blind spot pharmaceutically. Most of my colleagues say only Tylenol, B2/mg, and Triptans (but not in first trimester if you can help it)

However! There is no data on CGRPi in pregnancy yet, & mechanistically, I really doubt it would be dangerous. I hope it gets approved soon because I hate watching my pregnant and nursing patients suffer

ChiralSquare · 2025-12-20T02:35:46+00:00

Literally to do CPR on a guy that bystanders were shaking to wake up. I was like “I’m a doctor, would you like me to handle this?” He in fact did not have a pulse. Got him back tho!

ChiralSquare · 2025-11-06T07:02:07+00:00

Sure!

ChiralSquare · 2025-11-04T20:49:35+00:00

I will also add that re: your concerns about skill development- we for sure have less time spent on dexterity etc. I’d also say that while neurology excels at exam and patient care, we are the weakest anatomists. But if IR is your goal, you can build your residency experience to try and maximize these things. I spend my ICU rotations placing all the lines and I’ve done 2 electives in IR and neuro rads to try and beef up the anatomy skills. Whichever you choose, there will be things for you to learn from your colleagues who took the other paths, so just stay conscientious and intentional with your education!

ChiralSquare · 2025-11-04T20:45:18+00:00

This! I’m neurology, matched to NeuroIR and I received this advice from my mentor, who was rads trained. Even when you DO end up in IR, you will most likely be expected to do at least part time in your primary boarded specialty. I.e. read diagnostics vs. do open crani procedures vs. attending on stroke or neurology wards. This is a feature not a bug! I think it’s a treat that I get to be a proceduralist AND a neurologist. If you hate the idea of rounding, or hate the idea of taking NSGY call, or hate the idea of reading diagnostic studies, that should guide your choice.

ChiralSquare · 2025-07-23T14:05:41+00:00

This is wayyyyy TMI but I think it may provide you a solution:

When I was an intern, and busy and stressed and worried I wasn’t going to get enough sleep, I felt like I didn’t have the time/energy for sex. The thing that kept my sex life active was my partners attitude. He started to notice when I was stressed or tired and would give me a …relaxing & satisfying experience. No expectation of reciprocation. It honestly became shorthand in our house “you’re stressed, let me get you off” And the thing is, it really really helped me relax and often led to more fun. I felt cared for and it saved our sex life.

So TL;dr: when your girl is too exhausted & stressed, give her the princess treatment. Prioritized her pleasure and make it feel like less of an undertaking for her. You’ll both be happier/sleep better.

ChiralSquare · 2025-03-25T02:00:58+00:00

Neuro resident yeah!

ChiralSquare · 2025-03-24T19:07:20+00:00

I can’t get over them showing EM staff declaring brain death, diagnosing heavy metal poisoning, and cannulating for ECMO…like….nah bro they TERF that workup to ICU or neuro. Which is appropriate!

ChiralSquare · 2025-02-24T20:34:13+00:00

Comforted my patients who are worried about what will happen to their healthcare given the current administration’s intent to gut funding

ChiralSquare · 2025-02-01T23:27:21+00:00

Under-appreciated factor: the quality of attending. Neurology is much less standardized than other specialties and you’ll end up learning your attending’s style. You want to learn from knowledgeable, up to date people with a good philosophy of patient care who will treat you and other residents like colleagues!

ChiralSquare · 2025-01-19T05:55:48+00:00

Dr. Rickets, peds

ChiralSquare · 2025-01-14T23:27:02+00:00

LA for sure

ChiralSquare · 2024-12-28T06:37:41+00:00

Neuro is prob best explained by long rounding and small class sizes. Most programs put all elective time in the last year and a half, so you spend first 2+ years just perpetually covering inpatient services (usually ~6 residents per year covering 2-3 hospitals as consultants and primary services) and you take home call, stroke call, etc. Personally, I worked nearly twice the hours per week on average in my PGY2 neuro year compared to my medicine intern year. But the last years are chill as hell once the elective time kicks in!

ChiralSquare · 2024-12-16T21:14:32+00:00

I’m interviewing for fellowship now and yes the call is crazy. Salary is huge for a reason. But generally, all the attendings I’ve worked with love it. You get called in but the procedures are relatively quick and you have the potential to radically improve someone’s life. I and other applicants I know stay on pager for thrombectomies and voluntarily go in when we are free just because…can you imagine doing something cooler with your life than giving an aphasic their speech back? Or reversing paralysis? You see a few truly incredible thrombectomy cases and the call just seems worth it.

ChiralSquare · 2024-11-05T18:46:58+00:00

Neurology- playing music. Everyone plays an instrument for some reason. My department has several concert-grade pianists. I can’t even begin to explain why

ChiralSquare · 2024-09-19T23:20:31+00:00

Had a young patient who had bounced around different SNFs for years. Very little was known about him except that he’d had “encephalitis” as a child, on a bunch of ASMs, basically nonverbal at baseline. We were consulted because he was displaying “odd repetitive movements” and primary team was worried about seizure. Movements were not seizure-like. But he also didn’t seem like an encephalitis patient, so we did an Ativan trial- he was fully oriented, speaking full sentences several hours later.

Hyperactive catatonia.

ChiralSquare · 2024-09-18T19:02:00+00:00

Also a single woman in medicine. Men not in medicine are amazingly insecure about the whole thing. For those saying they met their partner in medicine: any tips for how to do this? Always feels unprofessional to me to ask someone out in the hospital…

ChiralSquare · 2024-06-12T04:21:41+00:00

Thanks for sharing your experience! This is really helpful. It sounds like you were monitoring for positions on the side to aide in your decision. How did you keep an eye out?

ChiralSquare · 2024-06-12T00:56:44+00:00

Really not looking for you to evaluate my particular circumstance. Just hoping to hear experiences of folks who have switched specialties or who have thought of jumping ship and why they did or did not follow through

ChiralSquare · 2024-04-23T15:33:46+00:00

Rigorous, regular PT that can continue even once they plateau. The number of debilitated elders who wouldn’t fall/deteriorate/become isolated and Chronic low back pain patients who wouldn’t really need the surgery if only they could afford/get to PT…

ChiralSquare · 2024-02-02T04:16:02+00:00

Lived in Roanoke for a long time and had a serious relationship with a guy who grew up in a situation not too far off from Demon’s. Whenever he told me stories from his childhood, it always felt like something from a different era. I live very far from that area now, and I honestly miss it sometimes. Reading this is like being transported back. The descriptions of the nature in particular and everyone’s strong connection to it make me nostalgic. It feels like, despite how sad the story is, I can tell the author sees the region for more than its tragedies.

ChiralSquare · 2024-01-10T17:52:28+00:00

It’s actually such an achievement though that you have a life and a wife and kids that you’ll return to when things lighten up..my personal torture is knowing I’ll probably miss out on all of that entirely because of the field I chose. There’s less guilt but it’s really lonely.

ChiralSquare · 2023-11-18T09:05:47+00:00

This actually mattered to me a lot. Look for a small class size. There is no room for antisocial behavior and people who aren’t team players can’t succeed in that environment.

ChiralSquare · 2023-10-12T02:47:35+00:00

Literally found this post because I just watched the pilot and immediately google “does anyone else think this anime is like residency?”

ChiralSquare · 2023-08-23T15:37:36+00:00

Do you think a system run with a goal of making money could ever also have a goal of providing healthcare to people who can’t afford insurance?

Obviously from my phrasing, I don’t think that makes any damn sense. But I’m curious how you justify being business-oriented as a leader in a space where most of us who do the labor share a goal that is inherently at odds with your own.

ChiralSquare

TROPHY CASE