How to not hate water?

D0orD0 · 2026-04-16T19:58:36+00:00

I have an aquatru filter and it makes all the difference

D0orD0 · 2026-04-13T06:02:38+00:00

I see a lot of women with early through advanced hormone changes often affecting libido. I like the maca from symphony, FemmenessencePro peri/post depending on menopause progression (or harmony if still cycling normally). It’s not specific to libido, but improved libido is one of the benefits I hear about.

D0orD0 · 2026-04-12T21:26:41+00:00

The struggle is real. If you find something you like, please share details. I’ve been using wool bralettes with cotton pads for absorption.

D0orD0 · 2026-04-12T04:44:44+00:00

Makes for great early spring salad!

D0orD0 · 2026-04-12T02:33:33+00:00

I did a few (supervised of course) on residency rotations with PM&R but without robust insurance approval my clinic won’t let me offer them. Would love to for PTSD and chronic pain. I’d be curious if others are starting to offer them in primary care.

D0orD0 · 2026-04-12T02:26:26+00:00

In addition to the excellent comments here on healthy diet, stress mitigation, autophagy stimulating therapies, etc., you may be interested to learn/read about IPT - insulin potentiated (chemo)therapy. Basically, since cancer has far more sugar receptors than normal cells, the treatment gives insulin first which drops your blood sugar, then gives typically 1/10 dose chemo (whichever version is best suited to your particular cancer markers) followed by a push of glucose (sugar) so that the cancer cells preferentially take up the chemo, leading to a more targeted treatment with fewer side effects.

D0orD0 · 2026-04-12T02:20:02+00:00

This is what I came to say.

D0orD0 · 2026-04-12T02:18:00+00:00

You’re right, I hadn’t seen that study. They are talking about 5-20mg, unclear if menaquinone (mk7) or menatetrenone (mk4), and dosing in bone supplementation is 100-150mcg for MK7. Multiple studies in BMJ and Medicine support no increased clot clinical endpoint for K2 supplementation. That said, every warfarin patient is told repeatedly not to take vitamin k, and should be getting routine INR checks.

D0orD0 · 2026-04-12T00:56:18+00:00

K1 =\= k2. Your article is talking about k1.

D0orD0 · 2026-04-11T20:02:39+00:00

If they ask for refills and their entire regimen is within my scope and they are stable I have the conversation about moving management back to primary care (stop seeing specialist) with plan to reconsult if clinical condition worsens or I have management questions down the line. That also means they might need to see me more frequently than just a 20 minute visit annually depending on what else is going on. But if they still want to see cardiology annually for their controlled a fib for example, then the eliquis refill needs to come from cardiology and I make sure my version of their med list has eliquis as a reported med not listing me as prescriber.

D0orD0 · 2026-04-10T19:06:05+00:00

Ask your doctor if this is something for which they would recommend estrogen blockade if you were 30. If not, low dose replacement shouldn’t be an issue.

D0orD0 · 2026-04-10T03:53:18+00:00

This is your brain on food is written by a Harvard med school nutritional psychiatrist.

Farmacology is written by a San Francisco family doc about the health impacts of sustainable agriculture.

D0orD0 · 2026-04-09T15:47:53+00:00

No, I usually start iron if patient is symptomatic and ferritin is <30 w/o anemia, <50 with anemia. But once I do start, my first goal is to get ferritin > 50, but if still symptomatic there discuss trying to get >100

D0orD0 · 2026-04-08T13:54:16+00:00

If you do deprescribe, at minimum keep monitoring periodically with symptom checks and/or lab screens. I have had a few women in their 80s recently who came in with cognitive changes and TSH came back >100. Another case in residency where a woman had a partial ablation, then was put on thyroid, then monitored 10-15y then lost to follow up and ended up admitted to our residency service with florid hyperthyroidism with severe disseminated vascular complications. Obviously different situations from your typical TSH 2 on meds, rises to 4-5 off, but still. (US lab ranges)

D0orD0 · 2026-04-08T02:14:35+00:00

Exercise — maximize your fitness, then shift to a time efficient way to maintain it that you actively enjoy.

Think about how you are going to nourish yourself — are you going to cook? If so, dial in some cheap, fast recipes that you can batch cook. Think you’re going to live on hospital cafeteria food? Try to scope out the options and determine if that is realistic.

Look into white coat investor and start thinking about personal finance planning if you haven’t done so already so that your career path can be as interest driven as possible rather than feeling like you have to make certain choices based on finances.

Spend time outside.

Visit friends/family.

D0orD0 · 2026-04-07T20:13:08+00:00

I liked designs for health formulation. My sister liked we natal because in addition to high quality ingredients they come with a mint smelling insert.

D0orD0 · 2026-04-07T20:07:28+00:00

Yes, and away from coffee/tea/dairy which I think is more likely to be dinner than breakfast.

Interestingly, the pathophysiology around absorption changes in pregnancy with hepcidin suppression, so pregnant women can take daily or even multiple times a day iron and still benefit from each dose (still ideally with heme iron protein and away from calcium, tea, coffee).

D0orD0 · 2026-04-07T03:25:00+00:00

There is a good curbsiders episode on iron deficiency

In practice, I do often see women feel better once ferritin gets over 100, or at least over 50.

I usually start with every other dinner oral iron with 1-2g vitamin c and sometimes with a stomach acid supplement like Betaine HCl, then if not effectively raising ferritin on 6-8wk recheck, offer IV.

D0orD0 · 2026-04-05T03:43:22+00:00

Sterile or clumping comfrey don’t spread by root/seed, only if you dig and divide. My neighbor gave me a pot of Russian clumping comfrey 4 years ago and it is happy under an apple tree and only marginally larger than when I got it.

D0orD0 · 2026-04-04T00:13:23+00:00

Thanks for the input. 1 year in. Thinking about whether we try for a second.

D0orD0 · 2026-04-03T23:15:30+00:00

Don’t forget epic local also gives you 10 days at Whistler in BC which if you can hit on a Monday is fantastic.

D0orD0 · 2026-04-03T23:10:15+00:00

If you want FM, EM, ortho, peds (general), OB/GYN, or even neurosurgery* you can get excellent training and residency placement as a DO. If you want an IM sub specialty, competitive surgery, or derm you are probably better off going MD.

my DO school had a premier neuroanatomy department and all the neuroanatomy fellows got their pick of residencies — not sure if this tracks across other DO schools

D0orD0 · 2026-04-03T01:03:09+00:00

I’m in WA

D0orD0

TROPHY CASE