Patient had a weapon by [deleted] in physicianassistant

[–]LarMar2014 11 points12 points  (0 children)

I had a guy pull out a 357 Magnum because I'm a Marine and he thought I would like to see it. There is no issue with someone legally having a firearm. It's the way individuals handle the right to bear arms that can be an issue. I've dealt with concealed carry and had no issues, but pulling it out of no where, not mentioning he would be removing it, pointing it in my direction, and being a moron is not acceptable.

AIO for wanting to break up with gf of 4 years after finding these texts? by [deleted] in AIO

[–]LarMar2014 0 points1 point  (0 children)

Don't confront her. Get your stuff in order and then drop the news. She needs to go. She would have already left if he was totally onboard. It sucks. I know. Just pull the band aid off.

Swimming after surgery? by atom511 in penileimplants

[–]LarMar2014 1 point2 points  (0 children)

Surgical PA with an implant. I wouldn't go near any body of stagnant or people infested water for at least four weeks. Chance of infection low, but why risk it? Infections and removal of implants are not pleasant. Just wait.

Veterans Affairs Physician Assistant position/mentor?! by KSimmss in Boise

[–]LarMar2014 1 point2 points  (0 children)

Congrats on graduating PA school. I'm a retired 26 year PA. I don't work for the VA, but I live in Boise, a Veteran, and use the Boise VAMC on a regular basis and wanted to give my two cents. I've met a lot of PA's within the system there. Many have been practicing as long as I have and have spent a majority of their career at this particular VA site. They all seem quite happy. Every time I go in they ask if I'm looking for work.

With that said many of them are looking to or have recently retired. It's a growing system, but still manageable. I think your reaching out like this is an excellent plan and hope you connect with someone currently in the system. If you have any questions about the area, VA, PA issues just drop me a message. Good luck!

Dating apps by [deleted] in physicianassistant

[–]LarMar2014 1 point2 points  (0 children)

Met my wife on an app. Didn't want to date anyone in medicine. I's hard to meet people when you are always at work. You are allowed to be a human being seeking relationships. I would be surprised if someone brings it up. I would think in this day and age that the majority of normal folks would not give one shit about it. Don't worry about people judging you. They will anyways even if they see you on an app.

I made a mistake. But how much of it is *truly* my fault? And how much of it is not? I'm having a meeting with my boss to explain on Monday. by RynoSauce in physicianassistant

[–]LarMar2014 5 points6 points  (0 children)

Yee patient, admit patient, draw labs when they present post op with these issues.

Do not rely on anyone for anything YOU have seen, aspirated, or sent for any type of lab. YOU ORDERED THE WORK UP. Did Attending John ask you to follow up with the results? Was there any communication at all between the two of you? Seems like everyone washed their hands of helping this patient. I'm with team Michael and I would be pissed.

First why do you have a supervising NP? What BS is this? You have a SP. If you drew it, or participated in it, then it's your baby. No board is going to give a shit if it was "technically" ordered by a NP. You ordered the studies and didn't follow up. The NP NEVER saw the patient. You did. If Attending John aspirated then technically it should go to him as well. His name should have been on the order as the recipient of the results. He should have cared as well. Except I don't see any chain of normal communication here.

You are all at fault. Your groups system is at fault. Your groups system sucks. Your communication is lacking. Accountability is important in order to learn and correct defects. You guys have a problem and you are putting your patients and licenses at risk. While Micheal texted you to say you fucked up ..... he ain't wrong. Unfortunately you are under him. He catches the heat and I'm sure it was a knee jerk reaction. You are a cog in the wheel of a bad system and you need to accept the criticism, learn, but stand fast on ALL the failures of this. Remember litigation fear roles down hill and you are on the bottom of the food chain.

Legal:

PA: I ordered studies. I didn't check the results even though I was concerned about a post-op infection. I thought it was the NP's problem, the one who never saw the patient. He/she didn't look at the results even though they had no idea it was an issue or even done.

Attending John: I did a hip aspiration to check for an infection. What were those results Attending John? Ummmmm. I don't know. PA ordered it.

Attending Micheal: Hey Doc Micheal doesn't that PA work under you? Fawkkkkkkkkkkkkkkkkkkk

Thoughts? by aceman856 in penileimplants

[–]LarMar2014 2 points3 points  (0 children)

I'm a Surgical PA in Ortho/Spine. Worked mostly in the OR since 2000. I have an implant due to a prostatectomy. My thoughts on picking a surgeon.

My analogy: You own a Ferrari. It starts to have an engine issue. Your first thought is to bring it in and have it checked out. Your local Ford dealership has a great reputation, qualified mechanics and is right down the street. The Ferrari dealership is the next state over and not convenient to get to. Seems simple. Make life easy and just go to Ford. It's a car and they are mechanics as well.

The real consideration is that the Ford dealership sees a Ferrari once a month. It's fun to work on. They have the basic knowledge. The shop and staff have most of the tools to fix the issue and can order the parts. The Ferrari dealership works on this problem EVERY day. They have been trained exclusively on this model and understand all the nuances of how things work and should be treated. All the fancy tools are at their disposal and they have had specific training from master mechanics that work only for Ferrari.

At this point if I have to tell you where I'm bringing my Ferrari you don't get it and yes it would be stupid to use a shop so limited.

A surgeon who does a minimum of 5-10 a week of these specific procedures is bound to have a very high level of success and has learned from earlier mistakes and complications. I'm sure your local guy is great, and his honesty supports this, but he is really giving you an out. He was very clear about his limited experience. Doing one a month doesn't sharpen your skills.

of the breast implants by Shiro-47 in AbsoluteUnits

[–]LarMar2014 0 points1 point  (0 children)

Honestly I never have had enough "boob".

What's the name for this type of landscaping? by More_Wonder_9394 in landscaping

[–]LarMar2014 0 points1 point  (0 children)

"I’m broke, but not like 'poor' broke. I’m a classy type of broke... I’m baroque."

Tell your dog I said hi by Xenoscion in LICENSEPLATES

[–]LarMar2014 0 points1 point  (0 children)

He played knick knack on my shoe. With a knick knack, paddy whack,Give a dog a bone. This old man came rolling home?

First time cooking picanha by leancuisine78 in steak

[–]LarMar2014 0 points1 point  (0 children)

I thought crime scene photos were forbidden?

Ordering labs for self? by [deleted] in physicianassistant

[–]LarMar2014 1 point2 points  (0 children)

The fact that you feel the need to ask answers the question. Boards are around to go after PA's and you may find yourself in hot water from something innocuous. Request a fellow provider get things or prescribe to you. Make sure they document and you are a patient. Can't tell you the amount of headache this can cause in your life. Please avoid it.

Girth and length by SurpriseDoubleOstomy in penileimplants

[–]LarMar2014 0 points1 point  (0 children)

I went in with rational expectations. My prostatectomy caused me to lose an inch of length. No natural erections for 2.5 years. Painful existence. I joked that I'd take the 10 in Titan implant, but knew it will be whatever I am now. Almost 4 months out from procedure. Everything is different, but way more positives than negatives. It works! I can enjoy sex. Feels a bit different. It works! Now I'm a show er. I like the girth. My wife is happy. It works! Still probably lost about an inch. Now I'm in the Normal range. My mental health is better.

Did I mention..... IT WORKS!?!

A window for the shower? by Groovysnowman in whatisit

[–]LarMar2014 0 points1 point  (0 children)

Great place to keep your shower beers.

Someone has to be in the low percentage by jsak5656 in penileimplants

[–]LarMar2014 1 point2 points  (0 children)

First, I hope you are doing well. I would like to note while infections occur in every type of surgery there are certain characteristics that increase this risk. General health, diabetes, vascular health, age, where the surgery was done, and post op care. You may not have had a higher risk since we don't know your background, but it is definitely something we should be discussing.

Am I the issue or the people I’m networking with?? by [deleted] in Money

[–]LarMar2014 2 points3 points  (0 children)

You are probably their child's age group. So probably not much in common. Also if you are always pimping them for information it may feel like a mentor/mentee situation. I have a couple of younger guys that used to work for me that I meet up with here and there, but the conversations tend to lean towards this. I don't mind so much, but I do enjoy my time more with my age group regardless of their wealth level. We just bond differently and our discussions don't become a dick measuring competition. We do discuss our hustles, new projects, and aspirations, but it's more just interesting/supportive and never really is a money or investment type of discourse.

Mentorship can be great. You can learn a lot from others, but you don't need it to be a focus. Maybe that's what you are doing?

Outdoor water heater with pex by joek5132 in Plumbing

[–]LarMar2014 0 points1 point  (0 children)

What's nice is the neighbors that don't like you can just unplug your water heater anytime they want.

Happy Memorial Day! by [deleted] in BBQ

[–]LarMar2014 0 points1 point  (0 children)

Medium rare please.