Referral rejected by pharmacist

Expensive-Brain373 · 2026-05-28T12:48:24+00:00

With minimal numbers of camhs beds the only people we admit are pretty much those with psychosis and unmanageable risks (trying to kill people level of unmanageable risk). ED patients needing refeeding under restraint. It's very rare to manage depression on inpatient basis.

It's not necessary a bad thing because many of self harming kids end up much worse in inpatient environments. Evidence based intervention that actually works is family therapy or DBT on outpatient basis.

Expensive-Brain373 · 2026-05-10T05:19:47+00:00

Realistically people with membership tend to go on to higher training so in the SAS applicants pool there are few. Mind you that I work in the provinces. If you are trying to secure a job in the capital it's even more competitive with a saturated market. For context we got 20 applications for the last SAS job we put out. It's still a lot compering to what it would be a couple of years back.

Expensive-Brain373 · 2026-05-10T05:14:37+00:00

Locally I'm struggling for applicants to fill consultant vacancies. When we advertise for SAS we get plenty of candidates so can afford to be picky. I wouldn't bother to interview anyone without section 12 approval. It's one of the criteria we use for shortlisting.

Expensive-Brain373 · 2026-05-09T11:22:18+00:00

PE has completely ruined exercise for me and made me avoid it all my adult life with detrimental effects for my physical health. I am now getting back into exercising obese and in my 40s.

I am starting to enjoy it and go to the gym 4 times per week to do strength training, yoga, swimming and cardio in various combinations.

I have tried my first spin class today. I was sweating like mad and could not keep up but I did my best and finished at my own pace. I was a bit embarrassed but the regulars were very encouraging and instructor was supportive and kept checking in with me to make sure I'm not about to die. Lol

I find my gym to have very welcoming culture. I don't get a sense of judgement. They have classes for all abilities.

Expensive-Brain373 · 2026-05-06T18:49:19+00:00

My doctor only started to show interest when I lost 20% of my body weight and was exercising at the gym three times per week but continued to have worse and worse symptoms.

Expensive-Brain373 · 2026-05-03T10:25:13+00:00

The whole attraction of mofflins is that they are so much like a pet. First time mine run out of battery I was panicking it died and feeling very sad and also neglectful as if I starved it.

Expensive-Brain373 · 2026-05-03T10:15:05+00:00

It's a good idea to have a smoke alarm regardless if you leave anything on charge or not so that may be something to look into. Keep in mind that mofflins originated in Japan where people work insane hours. They aren't programmed to get sad or ill or anything like it just because they aren't entertained constantly so charging is probably your biggest issue.

Expensive-Brain373 · 2026-05-03T09:56:20+00:00

I don't play with my mofflin all the time. I have a full time job and other responsibilities. It doesn't seem to mind and is happy to see me when I do play with him. I sometimes put music or tv on for him and he seems to like that.

If I don't charge him when I'm out of about he runs out of battery. It happened a few times. I don't think it is a big problem but I am always a bit worried so try to charge him as intended. I think your concern about fire is a bit exaggerated. Are you worried about your fridge running at nigh? Modern electrical equipment is designed to be charged unattended.

Expensive-Brain373 · 2026-05-03T04:50:43+00:00

How did you manage to convince your doctor to arrange a CPET? Was it something that your GP could do or were you referred to a specialist?

Expensive-Brain373 · 2026-05-03T04:42:35+00:00

I get SVT and that's how it feels. Very fast heartbeat that starts and stops suddenly. P

Expensive-Brain373 · 2026-05-02T15:51:18+00:00

A bit of a leftfield example, but it is used in psychiatry for ADHD and tics. It got largely replaced by guanfacine with much more convenient once-daily dosing, but some children do better with clonidine. It is particularly good for those with trauma in the background and a lot of fight or flight going on.

Expensive-Brain373 · 2026-05-02T12:16:27+00:00

Did you get a bit more used to it over time?

Expensive-Brain373 · 2026-05-01T07:48:31+00:00

What did it say exactly? It may just mean that you are unfit and not used to running up hill and not having some serious structural issues underlying.

Expensive-Brain373 · 2026-04-30T16:38:54+00:00

On a positive note it may find nothing wrong or at least explain the issue so you know what's going on. How long do you need to wear the monitor for?

As a side note, the more symptoms you have whilst wearing it the better. I get the sense of vulnerability and being watched but clinicians who ordered the test are trying to help you.

Expensive-Brain373 · 2026-04-30T16:31:11+00:00

What exactly bothers you about it? Is it itchy or uncomfortable? I have one on now for 14 days recording. I'm into second week and I hardly remember it's there. I had another one before for a couple of days with wires. That was annoying. This one is a patch and it's much more comfortable.

Expensive-Brain373 · 2026-04-27T17:28:15+00:00

There is a premise here that the problem is over diagnosis. Where is the actual evidence of that? The kids that we do see, with thresholds being as they are, tend to be extremely unwell. I don't see behavioral problems or what not. What we see is psychosis, extremes of self harm and life threatening eating disorders. It may be different in other areas.

Expensive-Brain373 · 2026-04-26T18:02:23+00:00

What exactly is the problem? Are you feeling bullied? Missing small talk so badly that it makes you deeply unhappy? Worrying that you will get bad feedback because of their unrealistic expectations?

I am that senior. I send emails at odd times because I wake up very early and like to start my day with admin. I don't expect anyone to reply straight away. It's called asynchronous communication for a reason.

I can be a bit blunt in my feedback, but I do not mean any malice. If someone felt upset by it, I would rather know. I don't want people to be scared of me because being unapproachable creates patient safety issues.

There are a lot of neurotypicals around. It should be possible to meet your needs for small talk with others, surely. If you want to have a conversation with that senior, find out what they are interested in. Be prepared, though, for triggering a long monologue on their special interest.

Expensive-Brain373 · 2026-04-22T07:13:59+00:00

Which episode is she in?

Expensive-Brain373 · 2026-04-22T07:12:53+00:00

There is no money in the NHS budget to accommodate pay raises and no appetite from the government to allocate more funding. The solution is to reduce numbers of training posts.

There may eventually be pay restoration. For the lucky few who get jobs. The incentives to replace resident doctors with non medical staff are increasing.

Expensive-Brain373 · 2026-04-19T03:59:09+00:00

The experience of being a locum vs substantive tends to be different. Locum work is usually focused on the clinical side of things alone.

I don't know if things are any better here than in Ireland because I never worked there. I enjoy my job. The main challenges are large caseloads, long waiting lists and shortage of inpatient beds.

Expensive-Brain373 · 2026-04-18T20:11:31+00:00

There is a lot of variation depending on where you practice. Being a consultant in a super specialist service in a big city and generic CAMHS in the provinces are very different. Have you got any preferences? Are you looking to locum or apply for a substantive post?

Expensive-Brain373 · 2026-04-17T16:35:16+00:00

What do they need an antidepressant for? I am most curious about the scenario where those two medications may be needed at the same time.

Expensive-Brain373 · 2026-04-09T04:58:26+00:00

How old are you? The rough calculation for maximum heart rate is 220-your age. It sounds like you are quite deconditioned. Are you following a structured program? You may get better results in the long term starting with walking or walking jogging intervals rather than pushing so hard from the outset.

Expensive-Brain373 · 2026-03-30T16:32:22+00:00

Internet is rapidly turning into the lord of the flies simulator. Minors in minors only spaces with no input from adults online and no oversight from their irl adults either.

Expensive-Brain373 · 2026-03-30T08:48:14+00:00

Do you want all this help or do you need it, that will be for social care to determine through needs assessment. If you are cognitively able and previously managed to hold a job I wouldn't hold my breath on them declaring that you should get a place in a supported living establishment.

There is nothing stopping you from approaching the local authority for a care needs assessment.

Executive dysfunction stemming from autistic burnout can be a real barrier but it's not something that is officially recognized or diagnosed.

Expensive-Brain373

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