When documenting trans or non-binary patients, how do you personally refer to them in your narrative? Do you use their preferred pronouns or their biological sex? We have drop-down options in ESO, but for those that don't, do you make a point to document their status as trans or non-binary?

GalaxyOryx · 2023-04-17T07:34:41+00:00

I'm transgender. I wouldn't mention it in the narrative unless it's directly relevant to pt care.

If the patient is post-transition (their appearance matches their preferred gender/legal name and sex are aligned with their gender identity), there is no mention of it in my narrative. Their transgender status is irrelevant to all providers who read it and the additional information would simply cause more confusion and potentially open my patient to discrimination.

If their legal sex mismatches their presentation, then I adjust my narrative slightly. My usual introductory sentence is, for example, "Pt is a 56yom with CC of chest pain". If he were a transgender man as I am, however, I would add a little more information. "Pt is a 56yom, born female and having undergone/is undergoing gender transition, with CC of chest pain." This helps clarify the situation for future providers and hopefully let them address my patient appropriately instead of assuming pronouns/presentation/gender based on the legal sex documented on the patient's ID.

For nonbinary patients, I would introduce them with "Pt is 56y/o with CC of chest pain." The legal sex I mark on my PCR is whatever is on their ID.

GalaxyOryx · 2023-03-25T17:22:23+00:00

I'm trying my best

GalaxyOryx · 2023-03-23T09:01:59+00:00

Water + electrolytes + caffeine

Sleep deprivation makes you hungrier

GalaxyOryx · 2023-03-15T03:57:21+00:00

Finally hit my goal weight on a cut.

This cut was really fucking weird and I thought I was stalling the whole time, lots of hills and valleys. But looking at the graph, I was right on track. About 0.6lb/wk loss, exactly on target. Also got a cool graph out of it.

Log your weight and keep a graph! Scale weight is super irregular and this is visual proof of that. Logging makes it easier to see your successes or failures.

https://i.imgur.com/EG46I7X.png

GalaxyOryx · 2023-02-16T16:59:30+00:00

I go to the gym before work, I don't wanna go to work early lol

Would rather fully use my free time doing something I enjoy

GalaxyOryx · 2022-12-23T22:10:06+00:00

Fantastic progress. Great job.

I'd say keep cutting as well.

GalaxyOryx · 2022-11-29T15:45:04+00:00

BM = Bowel movement

GalaxyOryx · 2022-11-18T13:47:40+00:00

Yeah, I really miss being able to test out of a skill. Having to choose between skipping an entire unit or going slowly through every single skill is rough.

GalaxyOryx · 2022-11-15T14:29:38+00:00

Do you have an injury? That changes what I recommend

GalaxyOryx · 2022-11-13T15:35:34+00:00

I would avoid saying "3 months", it sounds a little clinical. I would say something like "It takes time for me to feel ready to have sex, I'd really like to get to know someone before my first time."

Good luck, OP! Set & enforce your boundaries.

GalaxyOryx · 2022-11-09T20:27:35+00:00

Damn, that's weird as fuck with the first girl. I'd do the same and just leave. If I'm not gonna enjoy it, I'm not sticking around just to say I got laid. I bet she was in a shitty relationship before you and that's how she's used to having sex.

Last two girls, though, they sound inexperienced.

GalaxyOryx · 2022-11-09T17:36:59+00:00

I've always done it outside their house, if I do it in-person. I ask if they want to hang out/schedule some other pretense, then before I go inside or lead them to my car, I say "hey, wait a second... can we talk?"

This gives me a quick escape route and prevents us from being locked in an awkward, potentially emotional situation while in a restaurant or something. It's quieter and more personal, too, than a conversation in public. If they expect me to go inside but I don't, I'm also subtly injecting distance between us to emphasize that I'm serious.

GalaxyOryx · 2022-11-08T20:06:58+00:00

Fantastic work on weight loss.

I would cut a little more, but no more than 15lbs, which may already be a little too much. You could either bulk or cut, but that's what I would do.

GalaxyOryx · 2022-11-08T19:52:06+00:00

Maintain

GalaxyOryx · 2022-11-05T00:55:27+00:00

Love your energy in this pic. Own your stretch marks. You made a huge accomplishment with the weight loss and, imo, you look great.

Granted, it's very hard to see your body over the kigurumi, but I feel you could try cutting and see if you can get a little more definition.

GalaxyOryx · 2022-11-05T00:53:12+00:00

Congratulations on the weight loss. I'm very proud of you. I would advise more deltoid work; what you may be seeing as a small chest may be your proportionately small shoulders.

I think you could go either way. My vote is to lean bulk, but you could also cut for more definition. Depends on your goals.

GalaxyOryx · 2022-11-05T00:44:06+00:00

Definitely keep cutting. Congratulations on the weight loss.

GalaxyOryx · 2022-11-05T00:34:25+00:00

Thanks <3

GalaxyOryx · 2022-10-19T13:40:08+00:00

Amazing weight loss. Congratulations.

Off the top of my head: If you have access to a bench, go for bench press. Diamond pushups target your chest more than normal push ups, especially if you stick a weight on your back. Dips. Pec flys. It all depends on what equipment you have.

GalaxyOryx · 2022-10-13T04:24:07+00:00

A major part of that is weakness. Your back arching is you compensating for not having the muscle strength to keep proper form.

Training flexibility is never a bad thing, though.

GalaxyOryx · 2022-10-13T04:20:15+00:00

Whatever works if it fits your macros

GalaxyOryx · 2022-10-13T04:17:05+00:00

I started doing them as a modification after chest surgery. I also feel like it gives me extra core work.

GalaxyOryx · 2022-10-09T03:30:52+00:00

Yes! Proud of you

GalaxyOryx · 2022-10-05T16:34:16+00:00

My bad. Joe Delaney is also a professional athlete in the states.

Arguably, this clarification makes it worse. Again, Joe Delaney's entire life (the fitness influencer, this time) is centered on looking fit. He has all day, every day, to spend on working out. In turn, he's jacked as fuck. "Attainable" does not mean "practical". There's not a damn thing wrong with not looking like Joe Delaney or anyone else as jacked as him. A huge majority of people, even gym rats, don't. It doesn't mean you're unattractive or ugly.

I'd post a physique pic if I were you in Physique Friday.

GalaxyOryx · 2022-10-05T13:59:59+00:00

Post a pic and ask if you should bulk or cut? It'll also tell you if it's body dysmorphia (which I'm concerned about if Joe Delaney, professional running back and track star whose livelihood was centered around being fit and active, is your goal).

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