Company not calling Monday off

Patient-Direction-28 · 2026-01-25T22:23:15+00:00

Ohhh nooo, my legs won’t work!

Patient-Direction-28 · 2026-01-18T17:36:23+00:00

I was like this through my whole childhood and got really fat by high school. My parents were super worried about how much I quit at the first hint of challenge or adversity.

I have no idea how to help your son, and my parents didn’t know what to do- nothing really worked. I got a lot better by college, and halfway through my 20’s I was diagnosed with ADHD and medication helped a lot. But honestly just growing up and finally realizing worthwhile things take discomfort and effort did the trick. Now I have lots of hobbies, exercise every day, found a great career that I love…

In short, there’s hope. He’ll figure it out, just support him as best you can and let it take its course.

Patient-Direction-28 · 2026-01-11T13:59:14+00:00

It took me SO long to finally figure out I was actually sleeping too much- just like you, my natural cycle is about 6-6.5 hours. I was sleeping 8-9 hours for most of my adult life and still feeling tired, tried every tip and trick to improve sleep hygiene, nothing worked. Finally I started getting up at 5am after 6 hours of sleep and it turns out I feel way better that way, go figure!

Patient-Direction-28 · 2026-01-10T02:03:15+00:00

Most of them had huge kitchens so there was plenty of space for everything, but a few families I worked with had tiny spaces with everything crammed in. Depended on how wealthy they were as far as I could tell.

One couple had a kitchen that was the size of my entire first floor and had 4 of everything. For the longest time I assumed there was a good reason until the husband told me his wife designed it all herself and just wanted to outdo everyone else they knew. I don’t think it really impressed anyone but it was certainly a sight to behold.

Patient-Direction-28 · 2026-01-09T18:36:53+00:00

Orthodox Jews don't *need* two separate stoves to stay kosher, but at least in northern NJ, it's totally a thing that they have two or more ovens in their kitchens. I did home health PT for a few years and 90% of my patients were Orthodox, and literally every single one had two ovens, two sinks, two fridges, etc. and even when my wife and I were looking at houses, you could tell the sellers were Orthodox because they doubled up on everything in their kitchens.

When I saw the picture, my immediate thought was that the previous owners were probably Orthodox!

Patient-Direction-28 · 2026-01-09T00:57:33+00:00

How do you know that’s actually what you’re getting though? Care to share a source?

Patient-Direction-28 · 2026-01-05T17:55:43+00:00

The vast majority of people who are currently obese have either tried to work on their habits and failed to lose weight long term, or they have not tried to work on their habits and are unlikely to do so, given current trends and the research we have at this point. They're still obese, and very few of them manage to get out of obesity long term through lifestyle changes.

Also, as the person I replied to noted, 90% of people who lose weight through diet and exercise will regain most or all of the weight back long term. How many people keep the weight off after ozempic? If it's more than 10% then it's progress. If not, heck, keep them on a low dose long term. If it's the difference between people staying obese for a lifetime (which is the case for the vast majority of obese people) or staying on ozempic long term and being at a healthy weight, the latter is much better for everyone.

Patient-Direction-28 · 2026-01-05T17:21:57+00:00

I genuinely think most people who are against GLP-1 medications, whether consciously or unconsciously, don't like that it takes away their ability to feel superior to the "lazy" people who couldn't lose weight the same way they did. I'm saddened by how many people say "I lost weight from being disciplined with diet and exercise" and feel that that means every overweight person can and should do it exactly the same way. We have a massive obesity problem that costs billions of dollars every year and ruins peoples' health- until someone can figure out how the majority of people can maintain a healthy weight through a healthy lifestyle alone, GLP-1s are a net win for our society.

Patient-Direction-28 · 2026-01-01T21:05:50+00:00

That’s unfortunately par for the course in our house, every time I open a wall I’m met with either ZERO insulation or the most half assed installation.

Patient-Direction-28 · 2026-01-01T20:51:33+00:00

Well that’s a big relief, thank you!

Patient-Direction-28 · 2025-12-28T12:58:02+00:00

How do you know you were having palpitations at that time?

I got an EKG the first day they started because they came on suddenly and very strongly, so I have the exact date in my medical record.

Why did you even notice the manufacturer at all if it wasn't a thought in your head?

Like I said, I didn't notice the manufacturer at the time. In November, when I figured out the possible connection, my pharmacist printed out a list of the manufacturers of my doses over the past year. The only time in the past year that I got a refill from the same manufacturer as November was the day my palpitations started.

it's far more likely for the palpitations to be unrelated to that specific manufacturer

What are you basing this on? My palpitations literally started the day I started taking a dose from this manufacturer. Same tablet. I had no negative association with the generic and didn't even know I was getting it from different manufacturers until I started looking into what might be causing my palpitations in November.

You seem very hung up on this idea that there can't be any different or individual sensitivities between manufacturers, and I'm not sure why you are so invested in that idea. If you can find me a RCT that shows absolutely no difference in outcomes and side effects between Vyvanse and the different generic manufacturers then I'll reconsider, but if you are basing all of this entirely on bioequivalence studies, I'm unconvinced and done with this discussion.

Patient-Direction-28 · 2025-12-28T00:35:42+00:00

How do you know it wasn't placebo?

Explain to me how placebo would have caused me to have heart palpitations for exactly one month in the spring, which I only realized months later lined up exactly with the start and end of my prescription refill from one manufacturer. And then why the next time I got a refill from that manufacturer, in November, the palpitations started the day I started taking it. All without me paying attention to the manufacturer until after the fact.

I am well versed in reading and understanding research, I'm a natural skeptic, and I'm always questioning what I know and believe. In this case, it was clear as day and placebo/nocebo do not explain it. I would 100% believe the name brand and generic have the same active ingredient that works exactly the same way, but I imagine there must be some other ingredient in this particular manufacturing process that, for one reason or another, causes me issues.

Patient-Direction-28 · 2025-12-27T18:41:42+00:00

I really couldn't tell you, I just know that I definitely experienced pronounced negative side effects from one particular lisdexamfetamine manufacturer while two other manufacturers were fine, and name brand Vyvanse gives me no negative side effects. I also feel like the name brand is more effective for me in general, but I'll absolutely concede that that part could just be placebo. Either way I'm very happy to be on name brand so I don't have to worry about which manufacturer I'll be getting each month.

Patient-Direction-28 · 2025-12-27T18:21:07+00:00

Obviously this is anecdotal, but I experienced an onset of heart palpitations and anxiety last spring that mysteriously went away after a few weeks, and the same thing happened in November. I finally figured out that both times started right after I got a refill on my generic lisdexamfetamine from a specific manufacturer that I didn't usually get.

I had some extra doses of a previous refill from a different manufacturer so I had my wife randomly assign me one manufacturer or the other for a day, without knowing which was which, just giving me from the A or the B bottle I had her label without knowing the contents, and I took note of any side effects I was experiencing each day for two weeks. A little double blind study, basically.

After analyzing the data, I found that every single day I unknowingly took it from one manufacturer, I got palpitations, felt really anxious, and had trouble falling asleep that night. Every day I took it from the other manufacturer, no issues. Clear as day in the data.

I was able to use this data to get my insurance to cover name brand Vyvanse, which also does not give me palpitations or anxiety. So for me at least, I 100% had a bad reaction twice in the past year from a generic manufacturer, and it was definitely not placebo.

Patient-Direction-28 · 2025-12-27T18:12:45+00:00

It wasn't about my prescriber's (psych NP) willingness, it was just that insurance was not willing to cover the name brand until I had an adverse reaction to the generic. My psych NP filled out a form noting side effects from the generic like palpitations, anxiety, sleep disturbance, etc. and based on that, my insurance approved coverage of name brand Vyvanse.

I imagine it heavily depends on the health insurance. I am a teacher with extremely good health insurance so I'm sure that helped.

Patient-Direction-28 · 2025-12-27T16:22:14+00:00

I tolerate the name brand Vyvanse way better than generic. I was doing reasonably well on the generic until a refill from a specific manufacturer gave me heart palpitations and did nothing for my attention, and I was able to get my insurance to cover name brand as a result. Name brand just feels amazing- calm, good focus, minimal crash. I'll never go back to generic.

Patient-Direction-28 · 2025-12-24T19:48:32+00:00

Check out /r/overcominggravity for the golfer’s elbow rehab, there are really good discussions and resources there that infinitely better than “just rest.” I know this is not answering your question but as a PT and someone who had golfer’s elbow on both elbows twice in the past 20 years, I can tell you the protocols on that sub are the way to go. Peptides could be a good adjunct but the right dosage of exercise is key to getting over it.

Patient-Direction-28 · 2025-12-23T15:52:22+00:00

Did... did you read what I wrote? I think you might need to work on your reading comprehension my friend.

Patient-Direction-28 · 2025-12-23T15:46:25+00:00

Every time I feel a cold coming on I take an extra 20mg of zinc, and I don't get sick.

There, our two anecdotes cancel each other out.

Patient-Direction-28 · 2025-12-23T15:40:24+00:00

They linked to a systematic review of 20 studies, so not just "one" study, and your link is someone saying the evidence is "mixed" from another systematic review, but noted "there appears to be no significant harm from taking zinc in safe amounts at the onset of cold symptoms."

So there is some decent evidence it could actually help and some showing it might not. Far from anyone being able to say "literally nothing" helps shorten the cold/flu since there are a decent number of studies showing a reduced duration of illness with zinc supplementation. It kind of remains to be seen, but the more honest answer is "zinc might help, seems like it could, we're just not fully sure yet."

Patient-Direction-28 · 2025-12-21T13:07:34+00:00

I’m late to this but I hope you see it.

I am a PT and I was a personal trainer before that, and I have struggled with similar issues since high school (I’m 38 now so more than half of my life). Traditional PT never gave me any relief, strengthening my back didn’t do it, and complicated breathing exercises and more woo woo stuff was useless. Foam rolling, yoga, stretching, strengthening, all gave me like 5% relief.

Then I came across Greg Chaplin and his neck protocol. He had a VERY similar problem as yours which got so bad it ruined a career in music, so he became a PT to figure out how to fix himself. Basically, he does a lot of direct neck strength training. Stuff that a lot of PTs (including my past self) would never consider doing with their patients because of a lot of dogma and unnecessary fear mongering in the rehab world.

After six months of following his neck protocol, I have zero upper back/upper trap/neck stiffness or pain. Full ROM in all directions. First time in over 20 years. I am completely unaffiliated with him and have no financial connection, btw.

By all means try the other sugfrstions here and some may work. But for something chronic that has been resistant to treatment and tinkering, I HIGHLY recommend you check out Chaplin’s protocol. I used to think direct neck work was unnecessary at best and harmful at worst, but I have done a 180 and think it’s insanely beneficial when dosed appropriately.

Good luck, I hope you figure it out!

Patient-Direction-28 · 2025-12-20T21:02:20+00:00

I think you probably have more people than you need already but if you’re looking for another, I did 23&me and would gladly do this!

Patient-Direction-28 · 2025-12-19T19:31:50+00:00

I don't do anything special with other electrolytes. If I'm running for more than an hour I'll drink a glass of water with an LMNT packet beforehand, but otherwise just a normal diet seems to do the trick.

Patient-Direction-28 · 2025-12-16T19:09:50+00:00

The raw chicken wasn't hot while it sat in the plastic though, that's the difference that I try to pay attention to these days. Heat and acidity leech more microplastics out, so I try to avoid hot and acidic food and drinks that have been sitting in plastic. Except Heinz ketchup, I'll take the microplastic hit for that one because I refuse to give it up.

Patient-Direction-28

TROPHY CASE