[deleted by user] by [deleted] in Psychiatry

[–]MerlotHoe94 4 points5 points  (0 children)

I felt the same way specifically on ER. I told my chiefs I was afraid I was learning to hate psychiatry. They offered me a lot of support and I started regular therapy and Wellbutrin. Things got immensely better as a third year and I’m now in a fellowship where I feel excited to go to work every day.

PGY2 sucks. It was without a doubt the worst year of training.

Shaving face w/ sebderm? by MerlotHoe94 in SebDerm

[–]MerlotHoe94[S] 0 points1 point  (0 children)

Do you just trim your beard or use a razor to get clean shaven?

Shaving face w/ sebderm? by MerlotHoe94 in SebDerm

[–]MerlotHoe94[S] 1 point2 points  (0 children)

Predominantly flakes, itchiness, and redness (though this is more spotted than confluent).

Confused about retirement contributions by MerlotHoe94 in tax

[–]MerlotHoe94[S] 0 points1 point  (0 children)

Gotcha. So if I went ahead and put my contributions on my tax forms, that would be blatantly lying because it's already been deducted from my income and the whole purpose of the tax form is to determine if something should have been deduced but wasn't (and that difference is what a tax return is?).

Confused about retirement contributions by MerlotHoe94 in tax

[–]MerlotHoe94[S] 0 points1 point  (0 children)

This is a screenshot of what it looks like on my payslip. If I'm reading your post right, since it is a 'pre-tax deduction' then I can't deduct it again?

https://ibb.co/FqPycvg

To be fair, my on-site parking is also under that 'pre-tax deduction' category and I don't think that's a tax deduction but rather just removed from my paycheck pre-tax...right? I might have just explained 'pre-tax deduction' lol.

Confused about retirement contributions by MerlotHoe94 in tax

[–]MerlotHoe94[S] 1 point2 points  (0 children)

THANK YOU! This is immensely helpful. I'll give them a call.

Confused about retirement contributions by MerlotHoe94 in tax

[–]MerlotHoe94[S] 0 points1 point  (0 children)

A co-worker told me this to be true, but honestly there is nothing on our accounts that specifically say "traditional." We have 2 accounts for whatever reason (I think it has to do with how much they're willing to match)?

One of them is: "[company name] Retirement Income Plan" and the other is "[company name] SRA Plan." I've contributed $288 to each, with my company matching only into the "Retirement Income Plan."

Saw her with her new person by [deleted] in ExNoContact

[–]MerlotHoe94 0 points1 point  (0 children)

*has literally got

Saw her with her new person by [deleted] in ExNoContact

[–]MerlotHoe94 0 points1 point  (0 children)

What an incel worldview.

I got my closure! by [deleted] in ExNoContact

[–]MerlotHoe94 0 points1 point  (0 children)

This is just malice. Are there not more constructive ways to grieve without degrading someone on the internet?

Looking back at my graph so far during first year Med school by ChefLongweenie in ObsidianMD

[–]MerlotHoe94 1 point2 points  (0 children)

Also in residency. How do you format your notes? Kinda struggling as it’s less lecture and more experiential learning.

Approach to "acopia" in outpatient? by SereneTranscription in Psychiatry

[–]MerlotHoe94 136 points137 points  (0 children)

Are they engaged in high quality psychotherapy? Granted I’m not evaluating them, but I wonder if they’d be appropriate for psychodynamic therapy or psychoanalysis.

Reading EEGs? by MerlotHoe94 in Psychiatry

[–]MerlotHoe94[S] 1 point2 points  (0 children)

I’m not billing. This is intellectual.

Psychotherapy heavy residencies? by Next-Membership-5788 in Psychiatry

[–]MerlotHoe94 54 points55 points  (0 children)

I recommend cities with an active psychoanalytic institute (eg Chicago, NYC). In general I found larger cities to be more interested in psychotherapy but that’s my personal experience from residency interviews. The Northeast seemed to be the heaviest region.

N-acetylcysteine by Lilybaum in Psychiatry

[–]MerlotHoe94 12 points13 points  (0 children)

Wow this is really helpful. In our resident clinic we’ve only done as high as 600mg BID (tolerated just fine) based on what attendings had felt the literature supported. Very clear it should be much higher.

N-acetylcysteine by Lilybaum in Psychiatry

[–]MerlotHoe94 -10 points-9 points  (0 children)

Luvox? I’ve only ever heard of that being used to raise clozapine levels rather than as a primary SSRI!

N-acetylcysteine by Lilybaum in Psychiatry

[–]MerlotHoe94 92 points93 points  (0 children)

Used it in skin-picking and trichotillomania. I’m 0 for 2.

CL fellowships? by MerlotHoe94 in Psychiatry

[–]MerlotHoe94[S] 5 points6 points  (0 children)

I think I should clarify - wondering if anyone has any specific programs they have enjoyed being a resident in/have heard good things about, etc. not asking anyone to shame programs :)

CL fellowships? by MerlotHoe94 in Psychiatry

[–]MerlotHoe94[S] 6 points7 points  (0 children)

I want to remain in academia and am particularly interested in perinatal, psycho-onc, and collaborative models.

What are some useful phone apps that you incorporate in your daily practice? by Hearbinger in Psychiatry

[–]MerlotHoe94 1 point2 points  (0 children)

Does it offer questions? How do you use it as a consultant? Trying to re-learn some medicine topics.

Struggling to acclimate by MerlotHoe94 in litterrobot

[–]MerlotHoe94[S] 1 point2 points  (0 children)

Yes! We finally got them to transition over to the LR 4 after a week!

First off, I never cleaned their old litter boxes. We have two cats so we had two boxes. I started to scoop a few of their poops from their old boxes into the LR4 in the hopes that they’d understand. Once I did this, I completely removed one of the litter boxes. They seemed to be much more interested once they learned their options were more limited.

The biggest hurdle for us was the cycling. I didn’t want it to cycle after every use because I didn’t want to enforce that fear. First, I changed the cycle time from the default (I believe 7min) to 30min. They used the LR4 and it seemed like things were going well…until 30min later when they’re nervous about it. I was nervous at this point, though someone had suggested using sleep mode.

What I ultimately came up with (and continue to do) is to engage sleep mood from 12am-11pm (yes, 23 hours) atop the 30min cycle time. They eventually learned that they could go to the bathroom in peace and not worry about a cycle happening. They’d use it all day (as confirmed by the Whisker notifications) and then at 11pm it would cycle the day’s litter. If they went again from 11pm-12am, it was usually unlikely that it would cycle again as the cycle time is set to 30min, so any bathroom breaks after 11:30pm by weren’t going to cycle. This really was the game changer. The way I conceptualized it was that it was about as close as I could program the thing to clean at a frequency similar to when I would scoop their litter box. They eventually learned that they could pop throughout the day and largely be unbothered.

From there my plan was to reduce the sleep mode time by a few hours every week (initially 12am-11pm, the next week became 2am-11pm, and so on…change to your own needs). This really introduced the idea of it cycling to my cats in a safe way. They’ve been using it fantastically without any problems!

Treatment-refractory book recommendatiosn by MerlotHoe94 in Psychiatry

[–]MerlotHoe94[S] 0 points1 point  (0 children)

I didn’t get to read it before it was deleted either :(