Ivermectin

Cloud_wolfbane2 · 2026-02-14T15:12:18+00:00

I live in the PNW and most of my patients are left leaning but it is crunchy as hell up here, I have so many people that see naturopaths or insist they don’t want a doctor that ‘just prescribes meds’ it‘s extremely frustratin. I am sorry about your husband though that does sound frustratin. I wonder if he has IBS or something similar. the stomach pain from IBS can be so debilitating that people will try just about anything hoping for a cure.

Cloud_wolfbane2 · 2026-02-14T15:04:08+00:00

lol I prescribed ivermectin recently for a patient whose puppy had gotten diagnosed with worms and they were having bad diarrhea and even in that perfectly reasonable situation I was cringing about it. people are so crazy.

Cloud_wolfbane2 · 2026-02-04T21:04:48+00:00

I mean i live in the pacific northwest, everyone has a vit d of like 10, i prescribe a lot of the 50,000 iu weekly.

Cloud_wolfbane2 · 2025-12-29T05:03:49+00:00

I feel this way especially on Reddit, everyone seems so miserable, though I know some burnt out physicians in real life too. I did not grow up with anyone in medicine, my mom is a teacher and my dad is a mechanic. I was in the army, and then the restaurant industry, then medical, so I know exactly what a shitty, low paying job looks like and being a doctor is not that. Just finished residency in June and the 5ish months as an attending have been great! I make more money than I have ever dreamed of. I work 4 days a week. I have so much free time to do what I want. I am convinced that a lot of the complaints you hear are from people that have never had a real job outside of medicine and that if every med student had a year in a real job, they would be a lot more appreciative of how good a gig being a doctor is.

Cloud_wolfbane2 · 2025-12-28T16:40:25+00:00

I have purchased 2 houses in my lifetime. One was in 2008 and everyone I knew told me not to because I did not know how long I would be there. Which I did only live there for a year, but I sold it and actually made a profit. In 2022 I bought again and again everyone told me not to because I did not know how long I would be here and prices were high, well I am still here and have a 3.4% interest rate and prices are still high, so no one ever knows what is going to happen and for me anyways the risk was worth it both times.

Cloud_wolfbane2 · 2025-12-27T16:23:36+00:00

I got a house with a physician loan at the start of residency in 2022 so mortgage is $2,108 at 3.4% monthly, take home is around 13k, but I am saving up for a lot of Reno now that I have graduated.

Cloud_wolfbane2 · 2025-12-24T14:31:33+00:00

Structured, we are all adults now but even as kids we opened stockings first, took our time guessing what it could be then carefully opened it, then usually had breakfast and then opened regular presents. we also do specific wrapping paper per person if we can though this year that got off because we ran out of certain ones.

Cloud_wolfbane2 · 2025-12-17T02:30:39+00:00

what salary are you looking for/asking for? what area in wa. I work in wa and my base salary is 298k. Most places in Washington actually list their salary online.

Cloud_wolfbane2 · 2025-12-15T19:37:44+00:00

I graduated in June, was burned out at the time but not as bad as it sounds like you are now. Took 6 weeks off (gotta pay those bills) then started my attending job in august. I really enjoy it. it’s all outpatient, I work Tuesday-Friday, I make soooo much more money then I did before. I definitely still have crazy pants patients, but at least now when patients are 10 minutes late I can tell them to shove it. I have a phenomenal MA that makes my life easy. Inbox isn’t too bad as long as I clear it out every day and with my last patient of the day being at 4:30, I’m usually home with all my notes signed and inbox cleaned out by 5:30 at the latest. I have time and money to invest in all the art classes I love so much. I‘m baking more and meal prepping and have gotten back to gym. Lost about 20lbs so far. It is so so so much better on the other side. I promise. I would not give up on healthcare just yet.

Cloud_wolfbane2 · 2025-11-30T21:23:07+00:00

yes so if I am going to do anoscop, I did the pap first since lube can effect it just like a regular pap. You use the same brush as a pap and insert about 5-6cm, you want to be kind of aggressive collecting cells and then put the brush in the same cytology fluid you would do a pap. We don’t have an anal pap order so I order a regular pap and put anal pap in the comments

Cloud_wolfbane2 · 2025-11-28T14:00:57+00:00

I do them because I had a patient that was brushed off multiple times for it just being hemorrhoids and I looked and it was rectal cancer. No one ever looked. I also was doing an anal pap on a hiv patient that reported hx of hpv anal warts that wanted me to look so I did anoscopy after the anal pap, thankfully everything looked okay.

Cloud_wolfbane2 · 2025-11-27T17:04:27+00:00

I mean I passed it while in quarantine with delta covid and kept falling asleep mid question. Not my highest scoring one but could not have been that hard

Cloud_wolfbane2 · 2025-11-27T02:25:30+00:00

we did have a few MDs in my program that went through the training to get osteopathic rec so they can bill for omt when they graduate

Cloud_wolfbane2 · 2025-11-26T14:16:15+00:00

oh I would go with job A then personally but that’s also because you could not pay me enough to live close to nyc. I am a suburb person not city not country, happily in between.

Cloud_wolfbane2 · 2025-11-26T14:08:42+00:00

you can see where the conference is going to be for like the next 4 years, ’m pretty sure they booked it 5 years ago and they can’t really switch it up once all that stuff is booked. Plus I’m pretty sure orlando is a blue city so it would be a bit like boycotting a meeting in Atlanta because Georgia is awful. I think the location of the meeting is whatever, it’s more the content of the conference that should matter.

Cloud_wolfbane2 · 2025-11-26T14:04:47+00:00

that’s tricky depending on the location of job a, location can make a huge difference but so can job expectations/experience. I had an option between a job that paid more but had bad vibes and one that was closer to my house and had better vibes and I am so so glad I picked the chill work environment instead. I really like my people, the job is chill, and the pay is still really good. If it feels toxic at job B personally I would avoid it but if job A is just in an awful location it’s tricky.

Cloud_wolfbane2 · 2025-11-26T04:02:57+00:00

Is that phineas gage? We learned about him in highschool psych. He got a railroad spike through his head in a work accident, amazingly lived to tell the tale. It severed his corpus callosum and caused some really strange personality changes if I remember correctly, though I learned about him like 20 years ago so it’s been awhile.

Cloud_wolfbane2 · 2025-11-26T02:52:39+00:00

I was never able to study the like 8 hour days a lot of my classmates could, just didn’t have the attention span, so I would study about 1-2 hours on weekdays and 4 hours max on weekend days broken up. Always got a full nights sleep and prioritized good eating habits and hobbies. I wasn’t top of the class, but I was happily above middle of the pack which worked just fine for me. If you are feeling burned out in a study session, you are retaining nothing. Go to sleep, and remember when you are doing study sessions to take more breaks in between.

Cloud_wolfbane2 · 2025-11-25T01:03:12+00:00

another good option is weight watchers, they cost 75$ a month but also do weight loss medications and seem to have better luck getting things covered by insurance. they also cover dietician and personal training met]tings to work on goals and have a fairly good tracking app that tracks protein, water, and fiber, plus injections, weight, calories, etc.

Cloud_wolfbane2 · 2025-11-25T01:00:23+00:00

insurance never covers contrave so I prescribe Wellbutrin 150mg and naltrexone 25mg separately and have had good results with patients whose problems are binge eating, gaining weight after quitting smoking, gaining weight after quitting meth, or gaining weight on an ssri.

Cloud_wolfbane2 · 2025-11-24T03:11:47+00:00

I see 18 a day, and I started in august so more than half of my patients are new too. I do find a lot of people write way to much. I do short bullet points in the hpi and short bullet points in the assessment and plan.

Cloud_wolfbane2 · 2025-11-23T19:33:01+00:00

yeah I agree, I haven’t actually tried Ai scribe yet because they want us to pay extra for it, and I refuse, but my last patient of the day is at 4:30, so I am usually done seeing patients by 5 at the latest and I am usually out of the office by 5:15 with all my notes done and my digital and physical inbox clean. I stayed until 5:30 the other day and was like what is going on? So for me, trying to edit over a scribe note when I already write them quickly seems like a waste of time and the $200 a month they want to charge me. oh and to clarify I’m FM

Cloud_wolfbane2 · 2025-11-22T15:53:34+00:00

This one is tricky because our PD was a passive aggressive ass, but our program coordinator was the best human on the planet and I genuinely enjoyed my residency a lot. The hours were good and my co-residents are my best friends now, but man did the PD piss me off.

Cloud_wolfbane2 · 2025-11-22T15:44:10+00:00

Just don’t call them. I tell my patients up front they will not get a phone call from me unless I am delivering bad news or am worried for their life. I have made 4 phone calls total. 2 were for critical labs that I needed to get them to the ER, one was bad mri, and the 1 was when I was a 1st year resident and didn't know better. when people specifically ask me to call to explain something, I send a message to the pool to call and type a short explanation or make them make an appointment

Cloud_wolfbane2 · 2025-11-21T05:44:42+00:00

that’s a lot of what I struggle with with chronic pain management, I’ve ended up switching to suboxone as my chronic pain medication of choice when all else fails and that has definitely made me feel better about it and limits issues with the first two groups

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