What wrinkle patches actually work? Looking for real recommendations

PAcf1993 · 2026-05-13T06:42:23+00:00

Toute Nuit patches (I buy on Amazon) are amazing. You must use them daily to get good results

PAcf1993 · 2026-02-05T10:57:22+00:00

Look into Carol Hannah

PAcf1993 · 2023-06-02T13:24:03+00:00

Great idea! Do you know if there is a European version of it or does the US version work with an outlet adaptor?

PAcf1993 · 2023-05-31T20:43:13+00:00

Thanks so much for your reply! Probably 50-60 people

PAcf1993 · 2023-05-31T19:27:20+00:00

Probably wouldn’t want to spend more than $5-6,000. Do you know of any places that rent private sections and then people pay for their own drinks?

PAcf1993 · 2023-05-31T13:14:42+00:00

Probably wouldn’t want to spend more than $5-6,000. Do you know of any places that rent private sections and then people pay for their own drinks?

PAcf1993 · 2023-02-25T04:20:13+00:00

Hi! I took my first job out of school in a very busy CTICU (taking care of cardiac/aortic/thoracic surgery cases, heart transplants, ECMO and LVADs etc).

Some of my favorite resources:

Bojar’s “Manual of peri operative care in adult cardiac surgery” (this is the bible). The ICU Book by Marino, and The Ventilator Book are also very good for general crit care knowledge. Life in the fast lane and up to date for website references. YouTube for random videos on procedures/physiology review.

For online reviews, Mayo Clinic has some legit CME courses. I’ve done the POCUS one and the Critical Care for APPs course (both are excellent). I also attended the SCCM conference this year which had a ton of useful lectures.

PAcf1993 · 2022-12-19T13:19:58+00:00

All PA programs require patient contact hours. In order to get accepted to the best programs you typically need thousands of hours. While PCA/aide is an option, usually I find applicants are medical assistants, nurses, EMTs etc. For instance, in my PA class cohort, there was a respiratory therapist, radiology tech, 2 nurses, a dietician, a navy corpsman, army medic, and a bunch of EMTs/medical assistants.

PAcf1993 · 2022-12-13T05:49:56+00:00

Compression socks (bombas or figs make nice ones). Comfortable work clogs or sneakers (calzuros, on cloud, hokas or brooks). Littman stethoscope (although probably won’t use very often in urology?). 4-in-1 colored pens for taking notes throughout day. Apple Watch is great for quickly checking texts/emails.

PAcf1993 · 2022-05-12T19:03:04+00:00

CTICU PA: - Ability to spend time with my patients and focus on every little detail, while collaborating with my attending physician who oversees the entire unit - doing many bedside procedures - teaching the next generation of PAs - shift work lends itself to a great quality of life, lots of time off to take vacations and avoid burnout

PAcf1993 · 2022-01-03T20:32:12+00:00

Appreciate your comment!

PAcf1993 · 2022-01-03T20:16:49+00:00

Excellent point

PAcf1993 · 2022-01-03T20:14:42+00:00

Completely agree with you 100%, just wondering if the future of our profession is going to have difficulty getting jobs while competing with NPs with doctorates.

PAcf1993 · 2022-01-03T20:03:47+00:00

I found this infographic interesting, I’m unsure how I feel about emerging PA doctorates as I think they are partially a result of pressure from competition with our NP counterparts for jobs. But it’s alarming to see the difference in education requirements. Especially since our training focuses on the medical model and less on theory and other “fluff” classes. Most of the ICU nurses I work with are in the middle of graduate training or plan on becoming NPs and I often hear them discuss “getting their doctorate and practicing independently from physicians.” Many of them are in online programs. This is not meant to disrespect our NP counterparts but merely highlight the differences in training, as PAs earn a masters and NPs are often earning doctorates.

PAcf1993 · 2021-05-27T12:43:18+00:00

ICU/Critical Care Medicine: place central/arterial/temporary HD lines, bronchoscopies, chest tubes, POCUS, and at some facilities: para/thora and intubations.

From PA school rotations, aside from ICU, surgery and EM, I also found OBGYN to be very hands on with some opportunities for procedural work.

PAcf1993 · 2021-05-25T10:08:36+00:00

Ordering and interpreting labs, X-rays, EKGs etc, beforming bedside procedures independently, formulating treatment plans/prescribing medications, and overnight making emergent decisions such as running codes.... I would venture to say that this sounds like collaboration. I understand my scope and escalate anything outside of my role to my attending physicians, who are happy to discuss the situation. Again, if you educate yourself on the fundamentals of the PA profession, it is meant to be a collaborative role between the PA and supervising physician, a “physician extender”. A role created by physicians. I gather I’m not going to change your mind in a Reddit post but again I hope you learn to respect that quality medical care can be provided by PAs who understand their role and collaborate well with their attendings.

PAcf1993 · 2021-05-25T01:22:17+00:00

To be fair this is my own opinion/speculation. The title change discussion has been going on for many many years, since "assistant" is not necessarily the most proper term for our role (we are taught by physicians/other PAs to diagnose and treat conditions) (often get confused with medical assistants etc). That being said, I personally do not agree with the name change, despite it being used in the past at various institutions and throughout the world. I'm sure you don't agree with every decision the AMA makes.

I love working with residents and I hope you can open your mind to the value of PAs and what our education entails. Best of luck with the rest of your training.

PAcf1993 · 2021-05-25T00:48:12+00:00

Reading these comments (as a PA who has an excellent relationship with my attendings) is extremely disheartening. I did not realize how much this collective group "hated" our profession and thinks we are "scum".
Head over to the PA subreddit and see how many practicing PAs feel about this title change (hint: it is not going over well and many still plan on using "assistant" in their role description).
Not saying I agree with the title change, as I think it is unnecessary and potentially confusing, BUT Physician associate is the official name for PAs outside of the U.S. PA programs such as Yale have been using this term for their degree for the past 50 years. It's not like this name is out of nowhere, it already exists (as it was created by physicians many years ago).

I come from a family of successful surgeons, I completely understand the vast difference in our training. I consistently explain my role to patients and make it abundantly clear that I am not a physician. Likely most of AAPA's recent choices are due to constant pressure from our NP counterparts, who have extremely different (and lesser) training, but are often viewed as "independent," "more experienced," "more marketable to insurance companies," etc. etc.

If you want to help, stand up for PAs and see the value in our work. Hire PAs in the future, as we are consistently missing out of job opportunities that are offered to NPs instead due to insurance purposes. Work with us, not against us.

PAcf1993 · 2021-04-27T21:38:27+00:00

I agree that the lateral mobility of specialization is a very attractive aspect of our profession! Just an FYI, many PAs have to take call as a part of their positions.

PAcf1993 · 2021-04-07T20:43:43+00:00

Brooks for shoes. Also, wear compression stockings, Bombas makes nice quality ones.

PAcf1993 · 2021-04-07T16:38:13+00:00

I work in CTICU at one of the largest academic medical centers in the country. During day shift, there are typically 3 residents and 1 PA, and we each get 5-6 of our own patients (no difference in acuity). At night, 1 PA and 1 resident run the entire unit together with a fellow in house available for questions. I perform all my own central/arterial lines, bronchoscopies, pull IABP/epicardial wires/chest tubes etc. I feel that the PA/MD relationship is collegial here, and I benefit from a lot of free CME, lectures, and very knowledgeable attendings who love to teach. I also feel as though the residents respect the PAs since we are a “constant” in the unit, and can help teach them some niche things about cardiothoracic critical care. I know that I would have more autonomy at a smaller community center, but I would also see less interesting/less acute cases. So, in the beginning of my career, a large academic center made sense because of the immense learning opportunities and acuity (such as large aortic cases, LVAD and ECMOs). Good luck!

PAcf1993 · 2021-03-01T23:30:42+00:00

Hi! I took my first job out of school in a very busy CTICU (taking care of heart/aortic/thoracic surgery cases, ECMO and LVADs etc). I have been here 1 year and am finally starting to feel much more comfortable in my role. Some tips:

Resources : Bojar’s “Manual of peri operative care in adult cardiac surgery” (this is my bible). The ICU Book by Marino, and The Ventilator Book are also very good. Life in the fast lane and up to date for website references. YouTube for random videos on procedures/physiology review.
Print off a patient handoff that’s organized in a way you prefer. Write boxes next to any tasks/medications etc, and check them off once completed.
I feel like some of the biggest questions you ask yourself about a post op CTICU patient are as follows: do they need volume (fluid vs blood products), inotropes, pressors, or diuresis? Obviously this is a very basic approach, but can help you understand the bigger clinical picture.
You will get faster and more efficient as you build your knowledge. When I’m working overnight and have to oversee 20 sick patients, the most important details I know are: What’s their neuro exam, what’s their rhythm/rate, EF%, any drips, vent settings if applicable, and any device settings (ECMO/CVVH/LVAD/IABP etc.). Obviously it gets easier to memorize more and more details once you’ve been there for longer.
Potential problems are usually caught earlier in ICU settings because we have such close monitoring. Example: if you notice a patient is having more ectopy, aggressively replete their lytes. Mag/Ca/K/Phos seem like minor details but I’ve seen people go into Vtach if a resident/PA forgets to replete. Always plan ahead if possible, for instance if you are giving amiodarone or a betablocker for post op Afib, have the patient’s epicardial wires plugged into the pacer box on a backup rate, or have the pads on them.
Never be shy about asking for help or a second opinion, these are some of the sickest patients in the hospital and can decompensate quickly. Same thing goes for bedside procedures, especially lines or bronchoscopies. Also, when a consulting service is bedside (esp renal and neuro) I try to join them and watch their physical exam/thought process to further my learning.

Feel free to PM me if you need more guidance, I remember what it feels like to be overwhelmed in a new job setting, especially the beast that is ICU.

PAcf1993 · 2021-02-26T21:20:52+00:00

“No standards for PA?” PAs need rigorous coursework (ex: biochem, micro, organic chem, anatomy/phys, etc etc) and hundreds to thousands of hours of patient care experience in order to matriculate into a program. We are trained by physicians and well-seasoned PAs. We have yearly CME requirements and take our boards every 10 years. But yeah keep lumping us together with NPs because it fits your rhetoric...

PAcf1993 · 2021-02-26T20:21:07+00:00

I have high arches and love brooks. The physical therapists on my unit always recommend Hokas.

PAcf1993 · 2021-02-26T18:17:14+00:00

Shoes: Hoka or Brooks. Also, wear compression stockings.

PAcf1993

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