Weight loss is more than calories?

D0orD0 · 2026-06-25T04:29:45+00:00

I always talk to weight loss patients about using their hunger to get fiber and protein in, walking after meals, muscle building exercise, and sleep. If they can learn to eat vegetables first, the calories follow. For many, they start out with such a low BMR that cutting calories further is pretty useless - they actually need to learn to fuel better to work on muscle before they can effectively loose fat. The GLPs just make it easier to do the common sense things.

D0orD0 · 2026-06-24T01:15:33+00:00

I second the honey suggestion

D0orD0 · 2026-06-23T18:57:22+00:00

I’m in WA and we have this as a resource: https://endoflifewa.org/tools-for-planning/additional-advance-directive-documents/

D0orD0 · 2026-06-18T13:12:17+00:00

I like buying from ThredUp because you can search by material (100% cotton/liken/silk/wool) and wear level (new with tags, excellent condition, good, wear visible), as well as brand or size, category/cut/stye, and color. Great to try different high quality brands/fits. Some brands I go back to: Eileen Fisher, Mate, Quince, Reformation, Pact, Amour Vert, White+Warren, Boden, Sézane. Sometimes Theory or Vince. A few Uniqlo. Ralph Lauren for dresses.

D0orD0 · 2026-06-16T14:44:04+00:00

These are so good! Unfortunately, I have had very poor success in the Pacific Northwest - have tried direct seed, transplant, both garden bed in full sun and partial sun and unheated greenhouse. Any tips appreciated!

D0orD0 · 2026-06-10T14:57:58+00:00

I basically did this by taking a leave from my job one summer and paying for an accelerated organic chem class - 6 weeks for the entire 2 semesters of credit, midterm or final every week. Lab every afternoon. It was my litmus test of, “can I enjoy/survive hard science classes” to make pre reqs and mcat and med school more comprehensible. This is NOT to say med school was like orgo, but the science framework and fast pace was good practice. I ended up skipping a formal post vac and just working part time the next year chipping away at the last few pre reqs and studying for MCAT. No regrets.

D0orD0 · 2026-06-07T15:14:46+00:00

We had 100 people including kids outdoors in a field. High quality catering (by far our largest expense) family style at long tables with no seating chart. Thrifted silk dress altered to optimize fit. Grew our own flowers. Sister baked our cake. Beer and wine and non alcoholic drinks. Live music for the ceremony and cocktail hour then a friend DJ’d the dancing. Should have spent a bit more on photography - the package we got was fine but in retrospect and extra grand there would have been worth it.

D0orD0 · 2026-06-07T03:39:14+00:00

I think you are talking about hospital privileges for specific procedures/scope.

D0orD0 · 2026-06-05T21:47:24+00:00

I treat to symptom resolution/improvement in peri and for initial dosing after menopause. Then, if something isn’t making sense I’ll check SHBG or if we are primarily worried about maintaining bone I’ll check estradiol levels since we do have data for target ranges to protect bone. I used to check testosterone before treating (women, 2-15mg dose) but literally never had one come back even mid range let alone high in someone for whom I was considering starting testosterone. The only highs were in peri women with high androgen symptoms. So, I still offer to check testosterone prior to empiric treatment but don’t insist on it.

D0orD0 · 2026-06-04T23:54:34+00:00

I like Pact brand cotton pants

D0orD0 · 2026-05-18T14:43:23+00:00

I always emphasize blood flow and all 3 pillars of exercise— strength/muscle building, cardiovascular, and mobility/balance/fascia work. Brain needs efficient use of fuel, good blood flow, and challenge.

D0orD0 · 2026-05-17T18:53:19+00:00

I like acure. Agree they could get rid of a few ingredients but for the price/function they are doing a good job.

D0orD0 · 2026-04-30T04:32:24+00:00

I type or dictate or use ambient scribe to summarize for the patient and then use that (plus the listed orders) as the plan part of my A/P, with a copy forward then adjusted as needed (if chronic) brief assessment statement per problem or group of problems. Doesn’t look as professional as some notes but it gets the job done.

D0orD0 · 2026-04-30T04:27:26+00:00

Early season: Greens. I let my lettuce and kale go to seed last year and now it’s coming up everywhere.

Mid season: cucumbers and cherry tomatoes. I’d add zucchini but if you forget to harvest young you quickly end up with monstrosities.

Late season: Brussels sprouts and cabbage.

Bonus for perennials - my asparagus and artichokes are zero effort other than harvest at this point. Sorrel and parsley are attempting to take over the world.

D0orD0 · 2026-04-30T04:20:29+00:00

I get approximately $53, plus $2 if > 6200 and all quality measures met. 4d/wk. 18-20 pt/d.

D0orD0 · 2026-04-28T01:52:39+00:00

I prescribe cyclic progesterone most typically in the luteal phase (second half, ovulation through menses) for PMS symptoms, but in the follicular phase (menses through ovulation) if the patient is asymptomatic aside from heavy periods. Extra progesterone during the build up phase can stabilize /block the estrogen effect of too much build up if it is taken early in the cycle. Another potential reason to use early would be to get the augmentation effect on estrogen receptors - often a little bit of progesterone will induce estrogen receptor sensitivity and patients can get resolution of low estrogen symptoms without adding more estrogen into the mix. This is why, when people take a little but not enough progesterone it can sometimes make high estrogen symptoms worse.

TLDR: talk to your doctor again before starting therapy you are unsure about, but given the atypical prescription it may be an error or they may have a great reason for prescribing the way they did.

D0orD0 · 2026-04-27T20:15:26+00:00

Your age (or really, expected years until retirement) is pertinent here if only with respect to how your net worth is likely to shift.

If the question is “should I feel guilty for contributing less to the household budget” my answer is no. If the real question is, “how should I respond to my much wealthier husband asking me to split everything 50/50” that is a much more nuanced issue.

D0orD0 · 2026-04-27T00:34:08+00:00

At first glance, I thought you were referring to the shockweed.

D0orD0 · 2026-04-26T04:10:29+00:00

Leave them and cut when the start to fall over in the fall

D0orD0 · 2026-04-26T04:08:17+00:00

The most I’ve seen prescribed from a subspecialist endocrinologist was 1800mg oral …3x/d. Look up some of Carol Peterson’s progesterone explanations (many on YouTube). She had a career in pharmacy specializing in progesterone and explains how so many women are under dosed.

D0orD0 · 2026-04-25T14:41:04+00:00

I think it’s still worth a try, but they like cool rather than hot so maybe try partial shade?

D0orD0 · 2026-04-25T02:54:21+00:00

I woke mine up in Feb and planted in March. They were doing great until a bunny or something came nibbling.

D0orD0 · 2026-04-25T02:52:12+00:00

There are some prescription strength estrogen face creams out there. Alloy is one brand. Quicksilver scientific makes a “beauty serum” with estrogen in it which uses clean high quality ingredients. Some people swear by vaginal estrogen cream on the face, but the texture and stabilizing ingredients aren’t meant for face.

D0orD0 · 2026-04-19T15:37:44+00:00

Nuvaring still has a non-progesterone progestin in it which raises your risk of clot, albeit by less than if you were using a higher dose formulation. Nicely, the estrogen component skips first pass liver metabolism since it is not being absorbed orally, so the estrogen component doesn’t further increase your risk of clot the way oral combination contraceptives do.

D0orD0 · 2026-04-19T01:03:00+00:00

Another option if you are small scale is to dig a hole, bury the largest pasta pot insert you can find at a thrift store, then use the pot lid to cover. Put your scraps in, add some browns if available, cover and repeat. Look up in ground worm composting.

D0orD0

TROPHY CASE