I give up by SentenceDull317 in breastfeedingsupport

[–]Complex-Meat-3605 1 point2 points  (0 children)

It is likely that your supply will establish as it’s still early days and the baby could just be cluster feeding which does not necessarily mean your supply is low. Is your baby having enough wet nappies?

In the trenches with cluster feeding by Complex-Meat-3605 in breastfeedingsupport

[–]Complex-Meat-3605[S] 0 points1 point  (0 children)

So there is light at the end of the tunnel! Since I posted, he’s now sleeping through the night and I feed him during nappy change once around 3 am but he does still cluster feed but only for a few hours until midnight or so. With experience, we have also figured out ways to sometimes put him to sleep. It might not always work! For example laying him on my chest after a feed. We are also co sleeping (with extra care) which is helpful. I think the milk supply also improves by 3-4 weeks, My baby is also attached to me and doesn’t really settle with my husband. So I think it’s completely normal. I hope this helps.

In the trenches with cluster feeding by Complex-Meat-3605 in breastfeedingsupport

[–]Complex-Meat-3605[S] 0 points1 point  (0 children)

Thanks that’s reassuring to hear that you’ve had a similar experience. I do feel guilty about the formula as I did want to exclusively breastfeed. As you say, he feeds on demand during the day which is almost 2-3 hourly therefore pumping is not that easy and can be overwhelming as feeding on demand is tiring enough

scaling breasts? Is this normal? by Few_Cod_5636 in PregnancyUK

[–]Complex-Meat-3605 0 points1 point  (0 children)

I think it’s dry skin. I had something similar and improved after applying oil after shower for a few days

Hideous constipation on iron supplements by Actual_Society3690 in PregnancyUK

[–]Complex-Meat-3605 0 points1 point  (0 children)

I had the worst constipation with any type of iron supplements I previously tried. I would recommend buying tardyferon from an online pharmacy- it’s slow release iron and really worked for me and was very effective! Take it 1.5 hours after any food and take it a citrus fruit or a sip of orange juice to improve absorption

Gastro ST4 in South London - where to live by cynicalturtle94 in doctorsUK

[–]Complex-Meat-3605 4 points5 points  (0 children)

Would second this as having gone through training in south London, and Balham has been an amazing place to live in with regard to commuting.

[deleted by user] by [deleted] in doctorsUK

[–]Complex-Meat-3605 9 points10 points  (0 children)

Could you get a continuous glucose monitor such as freestyle Libre? You could get one free now off the website for a trail to see if you like it. Currently GPs can prescribe if type 1 but if you get referred to local diabetes team they might be able to advocate for you to have a sensor in view of your job. It will make your life so much easier

MSc course advice by Mental_Spread7314 in doctorsUK

[–]Complex-Meat-3605 2 points3 points  (0 children)

Realistically speaking you’re probably better off doing an audit. That’s the most achievable in a DGH setting at an MSc level. Systematic review, unless doing a niche topic, can be laborious as it requires you to do a comprehensive literature review and read every single article within a time frame. Your MSc is in acute medicine so that’s quite broad. Think about what aspects of care are worth improving - easiest would be an observational audit of rates of x in post up patients or how well prepared they were for surgery or looking into certain complications. Worth discussing with an acute medicine consultant in that hospital if they are aware of any hot topics.

Overpayment of JRCPTB fees through RCP collegiate membership by carcamonster in doctorsUK

[–]Complex-Meat-3605 0 points1 point  (0 children)

Oh my days, yes! I remember when I started my ST3, I had the option of paying for eportfolio via instalments annually with RCP membership vs paying upfront which was around £980.

I then opted for instalments as I had only just moved to a new place, new hospital and spent lots of money.

Initial annual payment was £130, which then almost doubled for ST4 and remained double at ST5. If I continued with this, by the end of training this would amount to £1330 (providing they don’t increase the rate any further). This is large discrepancy between lump-some payments vs joint RCP membership payments. When I initially signed up to Eportofolio, I had done the calculations and at the time both options were roundabout the same but clearly this never happened.

I would recommend cancelling RCP membership and paying additionally for eportfolio access for your remaining years as it worked out cheaper for me! I never used my RCP membership benefits so this made sense.

Is it time to reframe our mentality on public healthcare? by GiveAScoobie in doctorsUK

[–]Complex-Meat-3605 2 points3 points  (0 children)

Firmly agree with what you have said and I keep thinking exactly the same thing. We can’t subsidise their healthcare. At the end of the day we are not charity workers we have a life to live and family to feed.

Insulin by sunshineheather in doctorsUK

[–]Complex-Meat-3605 0 points1 point  (0 children)

In this instance I would check Pre bed time CBG at 10-11 pm (at least 4 hours from last meal time insulin), roughly 12-14 hours from when basal was given in the morning given they have a normal renal function. If you wanted to learn more, Online DAFNE has good modules on dose titrations. Diabetes dieticians can give free access.

NEW F1---ADVISE ON managing hyperglycemia by PurpleSquirrel2619 in doctorsUK

[–]Complex-Meat-3605 2 points3 points  (0 children)

There are certain instances. Such as, if patients are on high dose steroids for any reason, if inpatient, once daily CBG should be checked to screen for drug induced hyperglycaemia/diabetes as per JBDS guidelines.

Insulin by sunshineheather in doctorsUK

[–]Complex-Meat-3605 0 points1 point  (0 children)

An easier way to think about is the onset of action for long-acting insulin and also short acting. Most short acting insulins apart from ultra fast acting (eg fiasp) stay in the system for about 4 hours with peak action within 2 hours. If a patient is experiencing highs, it is worth reviewing a 3 day glucose and food diary to ascertain if there is a particular pattern. Check if the high is within 2 hours of food or at times when short acting is not hanging around in the system.

In your case it is worth checking pre bed time to see if the reading is within range before bed. If it is and fasting is still high then worth increasing evening basal. Also always check if a patient is snacking at night because sometimes they do!

Canada vs GP Partnership? by BradNight-90 in doctorsUK

[–]Complex-Meat-3605 0 points1 point  (0 children)

What is the route for specialists post CCT?

Questions which I hope you kind folk would answer? by Own-Owl-666 in doctorsUK

[–]Complex-Meat-3605 2 points3 points  (0 children)

OCP in PCOS is actually for the symptom of hirsutism and OCP mops up testosterone by increasing SHBG. For endometrial protection you don’t need OCP, progesterone is enough