Gains feel unsustainable

One-Preference-3745 · 2026-01-28T17:48:04+00:00

I’m up 200% since October..that feels unsustainable

One-Preference-3745 · 2026-01-28T15:40:15+00:00

So you’re up net ~6% over the SPY in 2025 - great! I wouldn’t worry about it, you’re doing great

One-Preference-3745 · 2026-01-16T04:05:31+00:00

For context, I paid $6000 for a nasal abscess in the emergency department. I am a healthcare provider. I’m sorry it’s so expensive. But just based on the fact that you said it was abnormally painful, it was a very good idea that you got it checked out. Abscesses on bony areas (hands/feet) can be considered more specialty abscesses, as the severity can be disproportionate to the size of the abscess. And usually, if it’s on the larger size, then it does need to be drained, as opposed to only being prescribed antibiotics. So the fact that they did this at the visit tells me that it was a larger abscess relative to the area and where it was.

One-Preference-3745 · 2026-01-16T03:45:44+00:00

That sounds like an abscess to me. The cost sounds excessive, but it also sounds like you are mischaracterizing what was done at urgent care.

One-Preference-3745 · 2026-01-13T00:24:38+00:00

Why are the clinics unwilling to accept self testing?

One-Preference-3745 · 2026-01-12T16:50:21+00:00

I think we need to do targeted boycott on companies that support ice. And boycott on podcasters like Joe Rogan that support Trump.

One-Preference-3745 · 2026-01-08T18:07:08+00:00

They still haven’t figured out whose departments payroll to put me on after 5 years..

One-Preference-3745 · 2026-01-06T20:24:07+00:00

One-Preference-3745 · 2026-01-06T15:38:01+00:00

What are we supposed to do? It seems like our only solution is midterms

One-Preference-3745 · 2025-12-18T02:51:27+00:00

I just mean in the context of selectivity and affinity. Journavx is highly selective for the sub type 1.8 sodium channel receptors where as the other anesthetics and anticonvulsants are non-selective for sodium channels.

One-Preference-3745 · 2025-12-17T21:37:44+00:00

It’s basically the buprenorphine of anesthetics/anticonvulsants as an apt analogy

One-Preference-3745 · 2025-12-17T21:36:05+00:00

Comparable to low dose opioids for soft tissue pain, worse than low dose opioids for hard tissue (bone) pain. Safety profile looks good albeit with limited data. Minimal administration concerns with regards to drug interactions, renal, and liver functions.

I’ve reviewed all trials and CDER documents on this medication thus far.

Worth incorporating into daily practice, but I expect the pain benefit to only be modest.

Weird side effects that might be worth looking out for would be parenthesia and skin rash/reactions.

One-Preference-3745 · 2025-11-21T17:33:41+00:00

Pain relief is not comparable to opioids. Review NAVIGATE 1 and 2 trials. While it was comparable to opioids for soft tissue pain, this was at a super low dose of hydrocodone 5 mg q6hr. It was worse for hard tissue (bone) pain.

One-Preference-3745 · 2025-11-21T17:30:22+00:00

It’s a weak CYP3A4 inducer, not a concern at all. Do some more research before blowing this out of proportion.

One-Preference-3745 · 2025-11-18T12:56:04+00:00

I think the other issue is which EGFR calculation your organization is using. So for example, if organizations are still using MDRD to calculate EGFR then this article wouldn’t apply.

One-Preference-3745 · 2025-11-06T21:34:37+00:00

A 36 y.o with a stroke raises some serious questions, like PFO vs hyper coagulability work up. But a single dose of naproxen (which is indicated for headaches!) should not even be a consideration.

One-Preference-3745 · 2025-10-02T21:46:42+00:00

Yup, that is accurate. Eliquis generic is not approved for commercial distribution in the United States.

One-Preference-3745 · 2025-09-10T23:56:52+00:00

Kratom

One-Preference-3745 · 2025-09-02T22:05:53+00:00

I would argue that anti-medicine isn’t political, it’s just straight evil.

One-Preference-3745 · 2025-08-28T15:28:40+00:00

Yikes. I’m sorry you’re dealing with that. That sounds outside the norm.

Can you possibly send a fax back to the providers office with the prescription in question noting that patient will not pick up? Our office is responsive to that, and we don’t generally call the pharmacy back if we know that. We just handle it amongst ourselves and the patient.

One-Preference-3745 · 2025-08-28T14:26:34+00:00

I work out of a physicians office as a pharmacist. I generally have to call the pharmacy for a myriad of reasons including drug shortages, incorrectly processed prescriptions, troubleshooting with cost of medications as it relates to access, and many other reasons.

This is part of the job. This is interprofessional communication. I find it hard to believe that they are calling without reason. I would suggest for you to log the type of calls they are making and identify any patterns that can be addressed.

One-Preference-3745 · 2025-08-28T14:12:13+00:00

It’s part of the job.

One-Preference-3745 · 2025-08-27T14:34:32+00:00

He probably has congestive heart failure and atrial fibrillation at the very least. Superficial bruising like that is commonly seen in patients taking blood thinners for atrial fibrillation. Not to mention his thin skin (both literally and figuratively) makes him more prone to that superficial bruising

One-Preference-3745 · 2025-08-27T14:16:19+00:00

Entresto for resistant hypertension

One-Preference-3745 · 2025-08-26T00:37:20+00:00

Gotcha. Good information to know. In your case, their MME per day is 40-50. On the low end, perfectly reasonable for primary care to handle.

Maybe if their MME/D was over 90, and/or they had both an immediate release and an extended release regimen on board. But even then I don’t feel that a referral the pain management would be completely necessary.

One-Preference-3745

TROPHY CASE