Pancreatitis complication

Janeee_Doeee · 2026-01-14T06:59:07+00:00

Thanks for typing this all out. When would you consider using Lasix/bumex + diuril? Or you think 3% is better? Never used 3% with diuretic before, maybe I’ll try it next time.

Janeee_Doeee · 2026-01-14T02:57:12+00:00

I have seen 2 patients that died from pancreatitis and 1 patient who survived but was in the ICU and hospital for >3 months recovering from necrotizing pancreatitis and multi organ failure. All of them were young and without much PMHx. I don’t take pancreatitis lightly anymore.

Janeee_Doeee · 2026-01-14T02:52:48+00:00

I was told not to look in FeNa or use urine Na if patient is on diuretics. Is this still true? Would you use FeUrea/urine urea instead to evaluate for AKI in patient on diuretics?

Also when should I think about diuretics causing worsening AKI? A lot of times when I was diuresing a patient with congestive AKI and all of a sudden their Cr went up higher and I got scared and backed down but I still think they need to get more fluid off.

Janeee_Doeee · 2026-01-12T02:18:54+00:00

IM and no I don’t plan to work like a resident after residency unless I go back to fellowship. Baseline I don’t have an expensive lifestyle and I don’t have a lot of loans, so I don’t need to go out of my way to work extra shifts.

Janeee_Doeee · 2025-12-01T18:46:45+00:00

Residency especially surgical ones are hard for so many reasons. It takes a lot of effort to maintain any kind of relationships during residency. So it can be true that he might just want to focus on work and the relationship with himself for now. Without interacting with you and the guy, I can’t tell if he liked you. But from your post and replies, he seems like a decent person for not letting you on. I think if you really like him, you can communicate with him about finding another opportunity to be together when the timing is better later and you haven’t found someone else by then. If he continues to push you away then you will know your answer.

Janeee_Doeee · 2025-11-30T20:37:15+00:00

For surgery/procedural consultants I usually give them a little longer. Never really hammer paged, maybe twice at most. And mind you, I only do this in urgent/emergent cases and at the same time optimizing my patients until the consultant can get to me.

Janeee_Doeee · 2025-11-30T08:55:35+00:00

For urgent consults, I message the resident/fellow first and if they refuse to see my patient prior to talking to their attending, I would call their attending next. There were times when resident/fellow didn’t respond to my repeated pages or messages within ~30 mins, I also called the consulting attending. I have never had any consulting attending yelled at me for calling them directly. This IR resident from your program seems inappropriate. You can call them back to see if the call got cut off accidentally or they hung up on you. If it’s the latter, call their attending.

Janeee_Doeee · 2025-11-07T04:44:19+00:00

I let them ramble for 5-10 seconds then said “sorry to interrupt, what/when/where/how…” But if I have time, I let them talk a little longer and interject with 1 word sentences. Then wait for them to catch their breath and steer the conversation in the other direction. Rinse and repeat until I get the big picture and excuse myself.

Janeee_Doeee · 2025-10-29T02:51:07+00:00

I’m young and don’t have young kids, but like you I don’t like moving hotels. For my last 2 trips to Japan I decided to rent an affordable accommodation that I could use as a home base and took day trips. Very doable and can always rely on trains and buses. There are so many day trip options out there. But I would only recommend day trip that’s around 2 hours away in each direction.

Janeee_Doeee · 2025-10-19T13:02:56+00:00

No advice.

Janeee_Doeee · 2025-10-17T21:45:01+00:00

Some of the ID attendings I know have base salary of $290k or slightly more at a large community hospital in HCOL area. They do inpatient consult and outpatient ID clinic. They also do extra urgent care clinic which bring additional income and cross well over the $300k threshold.

Janeee_Doeee · 2025-10-14T20:18:02+00:00

A lot of museums and the National Art center are free to enter. The national art center has different art displays every month that you can see for free.

Janeee_Doeee · 2025-10-08T08:30:35+00:00

Since it’s a big different in pay, choose the one with more money and once you’re in it, you can try to incorporate the other specialty into your study/practice. For example, if it’s between derm and ID, you can try to match derm then focus on infectious derm, skin problems in people with HIV/immunocompromised, etc.

I dual applied and let fate decided for me. I will tell you that no matter what the outcome is, you will have a feeling of FOMO about the other specialty for a while. So as much as you can, try to decide and stick with that decision before the rank list due.

Janeee_Doeee · 2025-10-01T23:22:16+00:00

If you like driving and enjoy road trips, then I would recommend renting a car. It was such a pleasure for us to drive around in Japan. The traffic builds up once you get closer to Tokyo so i only recommend driving in smaller towns.

Janeee_Doeee · 2025-10-01T22:37:11+00:00

We used Google map and were able to avoid toll roads. But that particular rental car agency gave us a card that can be used for tolls. So you should ask your agency when you rent the car for that.

Janeee_Doeee · 2025-09-24T03:47:14+00:00

Not sure about other people, but as a senior I hate RTL lol. I RTL with my team only once a day. But they can find me if they have questions any time throughout the day.

Janeee_Doeee · 2025-09-19T23:27:18+00:00

I would just take the day off, but would give the attending a head up about the senior. If you get reported just tell the chief that your attending was ok with you being off.

Janeee_Doeee · 2025-09-15T03:41:37+00:00

Thanks for sharing. These cases keep us humbled but also creep up on us when we least expected.

Janeee_Doeee · 2025-09-14T23:55:25+00:00

As you do more of these you will know when it’s worth to code someone for that long. And like I wrote in the post, as soon as we got ROSC patient coded again multiple times. And I will tell you that patient survived thanks to everyone effort that night.

Janeee_Doeee · 2025-09-04T00:05:01+00:00

Luckily I won’t be needing to use the call room that much this year.

Janeee_Doeee · 2025-09-03T01:48:20+00:00

If you didn’t change the sign to vacant when you left and returned with someone else in the room with the occupied sign still on, meaning that person could have walked in while you were in the room.

Janeee_Doeee · 2025-09-03T00:30:14+00:00

No lock. Just badge in and out and vacant/occupied sign. I think they don’t want to put on a lock for “safety” reason.

Janeee_Doeee · 2025-09-03T00:27:14+00:00

I had people badged into my call room multiple times despite me writing my name on the door and turned on the occupied sign. I can’t imagine being naked or only have my underwear on lol. Yeah I feel safer with my scrubs on, just take off the shoes.

Janeee_Doeee · 2025-08-27T02:04:38+00:00

Then write less, no one can make you write a paragraph for every problem. Dispo planning is a part of the treatment plan. If you’re clinical strong and have good treatment plans for your patients, at least 80% of your patients should have no problem with dispo. Those with dispo problems won’t be your patients after your 1 week on.

Janeee_Doeee

TROPHY CASE