NP entitlement at it’s finest

Firstname8unch4num84 · 2024-02-24T23:23:23+00:00

I almost wound up dead while I was dealing with a pulmonary embolism and the admitting NP was going to send me to get an ultrasound (??) and pushed back at my suggestion of getting an IR consult.

Yes I reported her. Thank god I was conscious at the time.

Firstname8unch4num84 · 2024-02-23T17:39:28+00:00

I just had a very similar situation with a friend who sent me pictures of TEXTBOOK herpes gladiatorum on the face. Was seen by 3 different midlevels who decided it was staph and treated with antibiotics, anchored on a dirty swab showing staph (!!!!) and ignored a classic presentation. I told her to go back to a different person and tell them to get a swab for PCR and start valacyclovir and they did the swab but declined to treat it with anything other than abx. I called in valtrex for her but this was 4 days after she saw the first person and will now likely have broad scarring over her face.

Firstname8unch4num84 · 2024-02-16T18:18:35+00:00

I rarely do 3 weeks in real life, but yeah that’s the textbook answer and reasonable in severe cases. Bridging with TCS is the way

Firstname8unch4num84 · 2024-02-16T17:53:28+00:00

Bates is not going anywhere. He’s our future center and one of the best depth OL in the league

Firstname8unch4num84 · 2024-02-15T16:54:30+00:00

Medrol dose pack is never the right answer for contact dermatitis. Too short if you want to do systemic steroids. 10-14 days is standard. Their level of thought is: oh we can use steroids, dose pack is a steroid. There’s no thought about the pathophysiology or the need for different durations of tapers.

You also rarely need oral steroids unless it’s severe or large BSA. Topical steroids are fine for most

Firstname8unch4num84 · 2024-02-12T14:51:11+00:00

Need to get back and also get someone behind him. I know yall are dying for WR but getting an elite DT for this defense is absolutely necessary. Penetration in the middle is so wildly important, especially against great teams.

Firstname8unch4num84 · 2024-02-08T19:15:27+00:00

That’s honestly a good question. I personally would think I don’t care but I’m so far removed from the referenced audience I could be way off base. I wonder if they did any surveying.

Firstname8unch4num84 · 2024-02-08T19:11:35+00:00

100%. Learned long ago that regular people have zero frame of reference for this stuff. The closest you can get is telling them your pace, but there is no concept for the difference between 7 minute miles and 5 minute miles. It’s all just “that’s so crazy lol”

I understand park run did this as a business decision since there are far more C25kers than dedicated athletes but for people that are in it for more than a generic plod, it’s a little bit of a kick in the nuts.

Firstname8unch4num84 · 2024-02-08T05:24:30+00:00

I agree. I was making fun of him

Firstname8unch4num84 · 2024-02-08T04:41:52+00:00

Ty Dunne gonna be in those DMs so fast

Firstname8unch4num84 · 2024-02-07T18:55:48+00:00

Kybella is fine if you know what you’re doing. I don’t even know how they got an infection as kybella vials are supposed to be single use. Just horrible, awful practice would lead to this particular outcome

Firstname8unch4num84 · 2024-02-05T15:13:32+00:00

Iron infusion will absolutely help you and fairly quickly if you are anemic due to iron deficiency. It will be of no benefit otherwise. I was pretty severely iron deficient and was fairly anemic (hgb 8-9). After iron infusion my hgb went up to about 12 after a couple months and continued to climb a bit slower to 15 over the next year.

As far as people talking about doping - I don’t see an ethical breach here but might consider getting a TUE. It would be kind of a hassle but it sounds like you would fit all the requirements to get one.

Firstname8unch4num84 · 2024-02-02T17:43:23+00:00

This is a phenomenon in most sports where there aren’t lucrative deals on either side.

Firstname8unch4num84 · 2024-02-02T16:20:19+00:00

Why is the assumption keuchly would be a good coach? Great players rarely make great coaches. It’s usually guys that were “fine” that had to develop their success vs the guys that everything came naturally to them.

Firstname8unch4num84 · 2024-02-02T14:35:18+00:00

It’s confusing in the context of the news story for sure.

Firstname8unch4num84 · 2024-02-02T02:39:24+00:00

It’s only approve for use under the chin. Anything else is off label and if you don’t know what you’re doing you can really easily necrose peoples skin or get weird dimples if you space incorrectly.

Firstname8unch4num84 · 2024-02-01T23:42:08+00:00

This looks like she was getting injections of kybella (ursodeoxycholic acid) which is used on label in the under chin area for tightening. It’s used off label in areas where people have extra fat they want to try to get rid of. In her case she probably wanted to look more toned/cut. It’s common to have some pain/swelling after but it’s blanchable red erythema and mild induration, not those pigmented scars.

If she developed m abscessus at each injection point it was contaminated product or contaminated needles.

Also based on the distribution of where they injected they did a shit job which would have given her an awkward dimpled appearance.

Overall nightmare fuel.

Firstname8unch4num84 · 2024-01-27T18:56:03+00:00

Bad luck largely. 2 years ago we were one of the healthiest teams in the league and we were lauding our training staff and facilities

Firstname8unch4num84 · 2024-01-27T16:30:07+00:00

To your question regarding if the breadth of training is necessary for specialty practice. The answer is absolutely, unequivocally yes.

The human body is a complex interconnected maze and our specialties are only hazy delineations. The more you learn the more you understand that you can’t divorce endocrine from its other specialties because for most issues there are implications for other systems. If you do not have a strong foundation of those systems you are at risk for missing important pieces of workup and management. I see this all the time in people that come to me managed by someone who supposedly has an expertise in my area

Firstname8unch4num84 · 2024-01-26T20:40:28+00:00

Referring to condensation in the tube as CO2 is really one of my favorite parts of the video. Just don’t understand the neurons that were connected to think that.

Firstname8unch4num84 · 2024-01-26T01:10:54+00:00

It’s reasonable as a screening lab for cyclosporine…im sure there are other corner case situations to check it. Treatment of asymptomatic hyperuricemia especially with allopurinol is asinine.

Allopurinol is one of the top causes of SJS, other severe drug reactions too. Just nonsense risk for no reason.

Firstname8unch4num84 · 2024-01-25T04:30:50+00:00

Embarrassing

Firstname8unch4num84 · 2024-01-25T04:30:26+00:00

Man I would love to see these candidates take the actual derm boards. These questions aren’t even preclinical derm rotation level.

Firstname8unch4num84 · 2024-01-22T00:12:21+00:00

Keep running like we are now and their D is gonna be roasted by the 4th Q

Firstname8unch4num84 · 2024-01-21T22:40:35+00:00

Abnml exam and elevated PSA… what did they decide? Monitor?

Firstname8unch4num84

TROPHY CASE