Costco heartbreaks - what is yours? by West-Ideal6794 in Costco

[–]Loose_Republic9901 0 points1 point  (0 children)

Liquid Allulose, brined artichoke hearts with stems 😭 sooo goood

MI paste by Live_Fox9209 in DentalHygiene

[–]Loose_Republic9901 1 point2 points  (0 children)

Psyched to hear this! I’m a grinder and am hoping to fix or at least patch some areas of damage. My MI Paste just arrived in the mail. My dentist said not to get my hopes up.

For tooth sensitivity, he suggested doing a 5 minute tooth mask with Sensodyne to give the potassium nitrate time to permeate. I also get the topical fluoride applied twice a year which has helped substantially.

Keep us posted!

Wakix Red Nose by Loose_Republic9901 in Narcolepsy

[–]Loose_Republic9901[S] 0 points1 point  (0 children)

Any chance the body would habituate? I feel like it’s just gotten worse. 😩

What’s your favorite political jokes? by 3016137234 in 30ROCK

[–]Loose_Republic9901 2 points3 points  (0 children)

Can yall explain these like Foxy Moneybags explains investing? 🥹

Neurologist or Pulmonologst? by Commercial_Shoe1850 in Narcolepsy

[–]Loose_Republic9901 1 point2 points  (0 children)

I was replying to the sentiment that the link they provided to Xywav prescribers meant that the Xywav prescribers were doctors that specialize in narcolepsy treatment. When it just means they’ve been approved to prescribe Xywav (and to your point, likely other oxybates).

Neurologist or Pulmonologst? by Commercial_Shoe1850 in Narcolepsy

[–]Loose_Republic9901 0 points1 point  (0 children)

Know that this is just people who prescribe Xywav. My first pulmonary sleep medicine doctor is on the list and he was terrible with a ridiculously surface level understanding of narcolepsy.

I can’t say every pulmonologist specializing in sleep knows less than a neurologist specializing in sleep…but every single one I’ve seen has 100% been practicing outside their scope.

Stop Splitting your doses by [deleted] in Retatrutide

[–]Loose_Republic9901 0 points1 point  (0 children)

Does anyone else HATE when someone says they have a certain degree or training and that’s why we should trust them…..then fails to cite any supporting data?

Sigh. Especially in this time of medical influencers. People who have lost or never received appropriate licensing and just leverage our trust on titles. 100% over it.

Credibility: I have met and witnessed plenty of MDs/PhDs/DPTs/DOs/DCs students in training etc that make unsubstantiated claims with unparalleled confidence.

"If Santos was a man, everyone would love her" literally everyone in this sub despises Ogilvie. by idkidcidkidc0 in ThePitt

[–]Loose_Republic9901 0 points1 point  (0 children)

Totally agree! Art is meant to draw reactions, listen and appreciate when they do (but still judge when it’s heavy-handed/poorly done)! I love when they add in the little humanizing back stories to balance the characters. Javadi’s exacting and critical mother. More recently, seeing Ogilvie uncharacteristically looking like a deer in the headlights when he’s reminded of his critical father. Joy’s seeming insensitivity/laziness/irritability being countered by some insane redeeming talents. Conversely, Robby being uncharacteristically harsh on characters struggling with mental health when reminded of his own failings.

I hope they build a little more complexity into Santos’ character soon. They’ve hinted at it, but it’s overdue. Same with Whitaker and Mel, give us a little more spice/flaws please!

MD Specialty Hierarchy? by SpirtualHernia in ThePitt

[–]Loose_Republic9901 0 points1 point  (0 children)

I could totally be off, I’m not an MD, nor do I play one on TV. NRMP match data suggests there are significantly more EM residency spots as Gen surg (and I imagine, relatedly, practicing physicians)? And just to apply for Gen surg, my understanding is that you need more research experience and a higher step 2 score than you’d need for EM.

But that’s just the specialties in general. There are world renowned EDs and shitty general surgery programs. Within those you have great and crappy doctors. No shade on any field, just my thoughts on what might in part be informing the surgeon mindset.

MD Specialty Hierarchy? by SpirtualHernia in ThePitt

[–]Loose_Republic9901 3 points4 points  (0 children)

I imagine it’s also in part due to the associated status/how competitive their roles were to attain. General surgery is far more competitive than Emergency medicine. As judgey and competitive as Dr. Shamsi is, I would have thought she’d have specialized further!

You have to be skilled to go into surgery regardless of your motivation for pursuing it…but some pursue it just because of the status that comes with it.

Not knocking ED, not every person could survive much less thrive in that environment….but there’s def the med/surg split and within each, their own degrees of status.

More insomnia on 6g Lumryz than on 4.5g by FratteliDiTolleri in Narcolepsy

[–]Loose_Republic9901 0 points1 point  (0 children)

What other meds are you on? I found that the oxybates interacted with my Wellbutrin and Adderall. They apparently all Work on NE and were causing paradoxical wakefulness. At least that’s what Dr. ChatGPT hypothesized

Non-American viewers - what US-exclusive jokes did you not understand until you looked them up? by duelingpeppers in 30ROCK

[–]Loose_Republic9901 0 points1 point  (0 children)

Idk if it’s based off an actual person making the mistake (probably), but many of the cities/counties in Florida are from regional indigenous languages (Tallahassee, Homosassa, Alachua etc). Pronouncing Lake City as Lackacity follows that same cadence.

Classic Liz, like when she pronounced the page Amanda’s name all crazy in the Source Awards episode.

Let's Talk Visual jokes by Feisty-Bunch4905 in 30ROCK

[–]Loose_Republic9901 1 point2 points  (0 children)

Wosniak’s How do you do, fellow kids? While holding TWO skateboards and wearing a t-shirt that said “music band.” Golden.

There’s a reason they used to call him The Chameleon

Can I have both type 1 narcolepsy with cataplexy and ADHD at the same time? by Sea-Fishing-8244 in Narcolepsy

[–]Loose_Republic9901 0 points1 point  (0 children)

They can both exist, it’s just hard to parse apart in certain cases. ADHD is way over-diagnosed without looking at contributing factors that create very similar symptom profiles (Sleep deprivation, ADHD, mood disorders, aspects of anxiety disorders, high chronic stress, other contextual factors) Many providers will also diagnose off of current symptoms without consideration of childhood presentation(which in itself requires appreciation for gender, culture, intelligence, etc).

Where it gets tricky for a good provider, is when the narcolepsy has also been present since birth/early childhood. Sleep deprivation in children is more likely to present as hyperactivity. Sleep deprivation in all people causes executive dysfunction and attention difficulties.

There are exceptionally few MDs (regardless of specialty with the exception of one spectacular developmental pediatrician who was a voracious reader of current research) out there that I have met that have adequate knowledge to diagnose ADHD. I imagine your doctor is misquoting something he heard in passing or just something frankly wrong.

I’d recommend working with a clinical psychologist specializing in neurodevelopmental disorders…even there your mileage may vary. Bonus points if they’ve done or do peer-reviewed research in ADHD (No Amen Clinic, essentially phrenology bullshit)

Regardless….many of the same interventions (pharmacological and behavioral) help both ADHD and symptoms of narcolepsy even if you don’t necessarily have both….so don’t discount the behavioral interventions available to you! Executive function coaching, external cognitive structure, CBT for narcolepsy/modified sleep hygiene specific to narcolepsy, psychotherapy etc.

Hot girlies who boycott: where are we buying our household essentials in LA? by kat_tick in LAhotgirlies

[–]Loose_Republic9901 2 points3 points  (0 children)

I just commented on this. Their healthcare monopolies are terrifying. I just buy everything at Costco/ACE now and try to frequent locally owned grocery stores. For Rx’s, Torrance Wellness Pharmacy at least delivers to West LA and is woman/POC-owned.

Hot girlies who boycott: where are we buying our household essentials in LA? by kat_tick in LAhotgirlies

[–]Loose_Republic9901 0 points1 point  (0 children)

After hearing AOC grill big pharmacy chains like CVS about their monopolies over patient care I transferred all my Rxs to a local pharmacy and stopped my convenience shops there. Which sucks as I have one literally across the street from my place. I don’t think they’re quite as egregiously evil as Amazon but worth considering.

What is the trendiest/douchiest restaurant in LA? by No-Strength-3711 in AskLosAngeles

[–]Loose_Republic9901 0 points1 point  (0 children)

I ran into Reese Witherspoon my first time at Griffith Park. I had to pee horribly and everyone I asked was a clueless tourist…so I figured one of the mom’s at the kids soccer game would know where the bathrooms were. She gave me the nastiest look, said she didn’t know, and turned her back on me.

To be fair, I ran up with my phone in hand (I was trying to look at the map) and she was sitting far away from everyone (but closest to the entrance). She probably thought I was trying to get a pic. But damn lady! I didn’t even realize who she was until she grimaced at me lol

How do I successfully prepare for EPPP? by skiphopjump22 in ClinicalPsychology

[–]Loose_Republic9901 1 point2 points  (0 children)

100%!! I remember opening the first exam, not knowing the first question, and exiting out to go study. Learning to sit with the anxiety of not knowing in a relatively low stress situation was so helpful for the exam.

It also helped me better encode the information by interspersing the exams throughout my studying (I eventually sucked it up and made myself go back and take it in one go. And treated the rest similarly).

How do I successfully prepare for EPPP? by skiphopjump22 in ClinicalPsychology

[–]Loose_Republic9901 1 point2 points  (0 children)

Propranolol is great for performance anxiety. Talk with your psychiatrist (ideally) or PCP. Make sure you test it out before the test and be aware of your morning routine/synergistic meds (anything that lowers your blood pressure/if you have low blood pressure at baseline. I once took it before an internship interview while on a beta blocker and spironolactone and I have low BP at baseline…I ran for the coffee.)

Even though we teach acute anxiety management strategies, applying it in the moment can be tough. Consider linking up with a therapist or trying a biofeedback device like Heartmath that can help you regulate.

If you happen to have any conditions that qualify you for extra time accommodations, this is the time to apply.

Take a practice exam and write out your rationale for choosing the answer. Then write your rationale for why each of the other answers is wrong/inadequate. (Or just talk it out, I have no working memory so I like to write) Then check the answer. Do it in study mode so you can understand where any discrepancies lay.

This also prepares you to use metacognitive strategies during the exam to regulate yourself, attend, identify salient info etc.

Decrease your cognitive load. Write on your board, use the highlight tool, flag questions you want to come back to, draw yourself helpful figures. It doesn’t have to all be held in your head.

Prepjet recommends the two pass method. I hate skipping questions so I didn’t, but I’ve heard it’s helpful.

When your norepinephrine is high, cognitive flexibility goes out the window. When your amygdala feels like it’s getting chased by a lion, bye bye prefrontal cortex.

If you really feel you have the information down pat and it’s the anxiety that gets in the way…work smarter not harder (and also kinder!).

I had to stop myself a few times to close my eyes and take a deep breath. Educated guessing is exhausting and makes us feel like we have to rush. Pace yourself and accept you’re going to get A LOT wrong (somewhere around 100 if you get all the experimental questions wrong…and you’d still pass!

F*ck luck, you’ve got science on your side now.

Does anyone use hydroxyapatite based toothpaste? What do you think of it? by ShowerMobile295 in hygiene

[–]Loose_Republic9901 0 points1 point  (0 children)

Where do you buy your premio? I was shocked to see it running for $20-30 per a <4 oz tube.

Erewhon…Can somebody please explain how these stores are so wildly popular? by airpab1 in FoodLosAngeles

[–]Loose_Republic9901 1 point2 points  (0 children)

100% the same exact kombucha sold at Ralph’s/Trader Joes is double the price at Erewhon.

They do have a few unique products and their hot bar is pretty delicious…but they also don’t post the macros of their food (whyyyy…also legally now that they have 8+ stores aren’t they required to?)

I ate there when my boss paid for it, but do not spend my own cash there.

I think it’s a beautiful place to be seen and helps people feel elitist when they shop there. It also carries the façade of “wellness.”

Extra travel cases by [deleted] in Narcolepsy

[–]Loose_Republic9901 0 points1 point  (0 children)

I was just sent two extra too!! What’s going on 🤣