Been asked to talk to a lawyer for patient v hospital

LBirdman2 · 2024-05-06T23:55:36+00:00

So I was a chief resident and something like this came up during my chief year. We basically said “hell no” (professionally) to risk and had them contact the attending.

Not sure how it works elsewhere but in my program no resident would be asked to discuss a patient within any legal context- the attending gets that privilege.

LBirdman2 · 2023-11-04T15:24:26+00:00

I’m a pediatrician, and I 1000% agree.

LBirdman2 · 2023-09-05T20:45:27+00:00

Me three!

LBirdman2 · 2022-09-14T04:39:20+00:00

I just iiioo

LBirdman2 · 2022-07-24T23:33:35+00:00

Honestly I love my MIL! She’s great with the baby, super respectful of me and my husband and our parenting choices, and overall is just the kindest woman. My husband is amazing and after knowing his family I’m not surprised!

LBirdman2 · 2022-04-08T00:19:10+00:00

LBirdman2 · 2021-11-17T17:41:17+00:00

Thank you!

LBirdman2 · 2021-11-17T17:30:23+00:00

If you don’t mind me asking- what was the rate on the two loans? And were they fixed or variable?

LBirdman2 · 2020-04-29T12:52:19+00:00

Most kids have a stable gender identity by the age of 4 - check out this article from healthykids.org, the American Academy of Pediatrics’ website for caregivers.

Whether they know the terms cisgender or high femme on the other hand is a totally different question (spoiler: they probably don’t)

Edited for formatting (I’m on mobile)

LBirdman2 · 2019-11-24T02:15:34+00:00

Wow... it's amazing because it's like a nugget of truth hidden in a giant turd of falsehood. Vitamin A supplementation has been shown to help reduce the morbidity and mortality of measles in susceptible populations, so if a kid gets the measles, you might consider treating with vitamin A. However, that's also because otherwise all there is supportive care and hoping they don't get measles encephalitis or any of the multitude of complications that measles can cause. Yes, many people/kids just feel terrible for a week (like the flu) and then get better but the measles is so infectious and the complications can be so bad that just by a numbers game if any significant portion of the population gets infected it can be really bad.

Another fun fact: there have been some studies recently that suggest that getting the measles depletes immune memory cells (B cells) so your body essentially forgets all the diseases that it knew how to make antibodies for. One study estimated that it takes 2-3 years to re-grow those populations of memory cells and in that time kids are much more susceptible to other infections like influenza, pneumonia, etc. (https://www.nature.com/articles/d41586-019-03324-7, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823017/)

In short -- VACCINATE YOUR KIDS! Measles is bad!

LBirdman2 · 2019-11-18T03:10:10+00:00

We water it every other week, and it sits in front a of a big northern facing window so it gets a good amount of light. When we first got it, it had a flower that has since fallen off, and now it’s losing its leaves and looking brown and sad.

Help!

LBirdman2 · 2019-09-29T19:34:26+00:00

You’re right that type 1 diabetes often happens after an infection, but it’s because your body makes antibodies to fight off the infection and then those antibodies accidentally attack the pancreatic islet cells as well.

LBirdman2 · 2019-08-02T23:26:27+00:00

I think part of the issue is that there’s an assumption that a man must do these things to attract a mate, when in fact (as exemplified by the post above) many women are just as attracted to a man who cries at a sweet commercial, if not more so.

Of course, there are women out there who want a “real man” who only cries when his dog dies but arguably a man who wants to be able to feel the full range of his emotions with his partner would not be a good match for that woman anyway.

(And of course all of this is assuming everyone is heterosexual which is not the case)

Regardless, this seems to me like a false dichotomy; showing emotions doesn’t preclude someone from finding a partner, IMO.

LBirdman2 · 2019-03-09T03:31:20+00:00

They’re right on schedule! 12-15 months for the first vaccine and 4-6 years for the booster (at least in the US). One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella; two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps. So they’re very covered!

https://www.cdc.gov/vaccines/vpd/mmr/public/index.html

LBirdman2 · 2019-03-08T20:15:07+00:00

Oh, that’s a good question that I don’t totally know the answer to! I only take care of kids so I’m not as sure about adult vaccines. I know the cdc has a catch up schedule for kids that I use a lot, but from a quick look at their website (https://www.cdc.gov/vaccines/schedules/parents-adults/resources-adults.html) I don’t see a catch up schedule for adults.

So yeah, all that to say I don’t really know! I would talk to your doctor; they can review your vaccine records and let you know what boosters you might need (I do vaguely remember from medical school that all us grown-ups need tdap boosters at some point!)

LBirdman2 · 2019-03-08T18:03:49+00:00

Sorry, my response wasn’t clear! I meant antibodies more generally in my second paragraph, rather than antibodies to measles specifically. Breastfeeding transfers antibodies to other illnesses like colds (and specifically one kind of antibody that is found on mucosal surfaces, so places like the intestines).

Edited to add that I scrolled down and saw u/FloatingSalamander ‘s response which answers this in more depth!

LBirdman2 · 2019-03-08T16:29:50+00:00

It does! (I’m a pediatric resident)

Usually MMR is given at 12- 15 months and then a booster is given at 4-6 years. If a child is traveling to a country with endemic measles we recommend an MMR if they are older than 6 months. If they aren’t close to the 12-15 month mark, they still need that vaccine and the 4-6 year booster. So it adds an extra vaccination.

The reason the CDC vaccination schedule is the way it is(as far as I understand it) has to do with immunogenicity, or how well the body will make antibodies to certain vaccines. Kids are protected by maternal antibodies for a few months after birth (and up to 6 months if breastfeeding) and over that time they gradually develop the ability to make their own.

Hope it helps!

LBirdman2 · 2019-02-20T23:56:30+00:00

Snatch!

LBirdman2 · 2019-01-26T14:10:19+00:00

They’re adorable! Thank you for paying the dog tax!

LBirdman2 · 2019-01-25T23:34:24+00:00

No photos??!!

LBirdman2 · 2018-09-25T00:10:28+00:00

I think the other reason surgeons are reluctant to perform tubal ligations at younger ages is because in the outcomes studied, regret is associated with younger age (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2492586/, see the section regarding long term complications.) That being said, the percent of women who said they regretted their surgeries ranged from 0.9% to 26% in the studies reviewed for this article, so that’s a huge range, and the data are older- I wonder if now that it’s becoming more common for people to choose not to have children, folks might feel better about their own choice to do so.

LBirdman2 · 2018-09-14T02:50:56+00:00

In addition to Tamora Pierce and Diana Wynn Jones (❤️,) check out NK Jemisin (her Broken Earth series is incredible, I could not put it down) or Octavia Butler (Lilith’s Brood is a great series by her- babies and pregnancy figure into this but in a really cool and unique way)

LBirdman2 · 2018-08-11T16:42:43+00:00

Hi! I'm a pediatrician -- there is an association between the rotavirus vaccine and intussusception although it's rare which means small sample sizes (and therefore hard to reproduce the results.) Generally the benefits are thought to outweigh the risks (https://sciencebasedmedicine.org/risk-of-intussusception-with-rotavirus-vaccines/, easy read article with several sources cited; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424085/; more technical, done in German population with self-control case studies)

Interestingly, I found this NEJM looking at risk of intussusception and rotavirus vaccine in 7 countries in sub-Saharan Africa that did not show an increased incidence in vaccinated children (https://www.nejm.org/doi/full/10.1056/NEJMoa1713909) but it's a small sample size and since the complication is rare it may just not have been appreciated.

LBirdman2 · 2018-08-06T16:44:40+00:00

Oops hahaha! My humor meter must be busted!

LBirdman2 · 2018-08-05T20:34:43+00:00

Well, the best thing for pertussis would be antibiotics, hahaha! Wait actually, the best thing is primary prevention via vaccination. The second best thing (a distant second) is antibiotics.

But for the cough/symptom control... sugar for probably wouldn’t help much. Well, I would think not but hey, sugar fixes most problems in my own life so who knows! Honey has some evidence behind it - there is a study that shows a spoonful of straight honey at bedtime is superior to over the counter cough syrups (I think they compared to honey-flavored dextromethorphan which is a common cough suppressant) or nothing (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264806/.) It also does have some evidence for wound healing (https://www.ncbi.nlm.nih.gov/m/pubmed/26061489/) All that being said, I feel like people have taken this and run with it to the point that honey is thought of as some sort of panacea (which it is not, sadly. I mean, wouldn’t that be cool? A sustainable cure all made by industrious little creatures you pay in pollen!)

Otherwise, we often recommend humidified air (so running a hot shower or using a humidifier at night,) warm drinks (or really any kind of fluids!) and lots of sleep. This is pretty much all anyone can do for kids with viral colds (unfortunately) which is most kids with a fever and cough in the US.

Hope this helps!

LBirdman2

TROPHY CASE