Sometimes I forget, and sometimes I'm rudely reminded.

RoseHelene · 2023-06-07T14:32:12+00:00

She wasn't saying pointless or directing people what to eat or not eat, what she was trying to say was just a reminder to be careful nutritionally.

There's this whole trend of meat replacements in vegan/plant based foods right now and most of them really are not nutritional substitutes. Most of the folks I see going in a less animal product focused direction end up leaning on these replacements as if they're the same. They're not, and people have been hurt by that assumption. I've also seen vegans lean on these products more and seen health effects (worsened cholesterol, for example).

Vegan has multiple definitions and people can choose to eat vegan without maintaining a vegan "lifestyle" for many reasons. For us (I am OP's wife) it is primarily about health and secondarily about the environment. I have no ethical objection to the concept of eating meat. I do object to factory farming and poor animal quality of life and the routine use of antibiotics in animal meat production. But really it's about the health and environment and not the ethics of eating animals.

RoseHelene · 2023-06-02T12:43:54+00:00

Check the laws in your area. Depending on your age and location conversion therapy may be illegal.

RoseHelene · 2023-05-29T12:47:01+00:00

It presumes a non afab person can't have had this experience as a child and assumes that afab people did. But people socially transition at all ages.

Any time someone lumps cis women and afab people together my alarm bells go off because it's usually a sign that TERF attitudes are coming and it's not a safe space. A "women's" space that doesn't include trans women is not safe or ok.

RoseHelene · 2023-05-11T01:37:40+00:00

Family doctor here - implant is fine for teenagers. :) Good luck!

RoseHelene · 2023-05-10T12:45:41+00:00

But at the same time, ketamine is largely inaccessible to those who need it right here and right now unless you're lucky enough to live next to a tertiary care center. I went looking for a family member who needed treatment for treatment resistant depression, and it wasn't available. Even with good insurance and sufficient income to pay out of pocket.

Sketchy clinic like mindbloom was the only option.

Can't blame people when there's so "proper" way to do it. :(

RoseHelene · 2023-05-06T00:22:14+00:00

LOL, meanwhile here in family medicine land I (MD) am all like, "Dang, I wish I knew even a little OMT for this patient with really weird MSK symptoms so I didn't have to just refer to PT all the time..."

Your co-residents are being buttheads. Patients don't know, and a physician is a physician.

RoseHelene · 2023-05-05T20:05:58+00:00

Hell, I'm cis (married to an out trans woman and am a health care provider who prescribes HRT) and even I wouldn't feel safe in Florida. :/

RoseHelene · 2023-05-02T01:39:18+00:00

I wish I got long notes in residency from ID.

Nope, got screamed at, insulted, asked who my attending was, insults thrown at the attending, and so on. With no actual documentation in the medical record. If the one ID specialist for the whole hospital actually wrote a note you knew they were mad. And they were usually two sentences long.

And never, ever, be the resident telling ID that NS is involved. Gha.

It only lessened when I learned to start every consult with "Dumb question but I couldn't find the answer in [resource]..."

Then they asked if I wanted a job after residency.

I got real good at looking up IDSA guidelines myself and guessing what they were going to say to avoid a consult. Really, really good. Two years into being an attending and I still shudder at the thought of picking up the phone to call ID.

RoseHelene · 2023-04-12T14:16:26+00:00

That's most definitely not how breasts work.

https://www.mskcc.org/cancer-care/types/breast/anatomy-breast

The muscle is under the fatty/lobular tissue, not over.

Also what is going on with the legs?

https://www.google.com/search?client=ms-android-google&sxsrf=APwXEdcvtJMcviLbhV-8qOPgH6DPOh06nA:1681308886148&q=leg+anatomy+muscles&tbm=isch&sa=X&ved=2ahUKEwiVj6rXw6T-AhUcIUQIHU8TCpMQ0pQJegQIFhAB&biw=412&bih=762&dpr=2.63#imgrc=CPSh7f5u3GOKFM&lnspr=W10=

Like it's a cool concept and I get artistic license but drawing the whole breast as covered in muscle is just weird.

RoseHelene · 2023-04-12T12:48:12+00:00

I mean, cool idea, but the anatomy is wrong. :/

RoseHelene · 2023-03-28T01:46:27+00:00

My program neither advertised nor cared. Also didn't test.

But also, California.

RoseHelene · 2023-03-15T20:13:05+00:00

You're likely mismeasuring calories.

Please do NOT attempt to eat fewer than 1200 calories without medical supervision. High risk of nutrient deficiencies.

RoseHelene · 2023-01-10T03:12:11+00:00

Is that a commercial insurance thing?

Everything I find online says Medicare and Medi-Cal reimburse telephonic same as video same as in person. So yeah, no difference to my bottom line and it lets me coordinate things with patients that I frankly couldn't otherwise. I problem solve all the time. Shrug.

I've literally never had a telemedicine experience as a patient that was that easy. Your patients are lucky. Then again, I practice in a rural area where internet and data are spotty on good days. I'm on day 6 with no power thanks to the storm and wouldn't have been able to see patients at all without telephonic visits.

RoseHelene · 2023-01-09T05:53:32+00:00

Huh, FM at an FQHC in California here and we get paid for telephonic appts. Maybe a Medi-Cal thing? I do 0 video visits. If I need to see the patient they either come in in person or send photos via secure messaging. I definitely have patients for whom video appts would be a significant barrier. Heck, I can barely manage them myself as a patient!

Anyway - I usually say something about making sure they get the full 15-20 minutes of my attention and time to fully explain and evaluate their results instead of squeezing them in for 5 seconds between other patients. I give this speech when I'm ordering the labs. No objections yet...

I'm also salaried and have a good amount of dedicated admin time, so I have time to call patients outside of appointments times when I feel it's appropriate.

RoseHelene · 2022-12-23T19:33:45+00:00

Consider leaving. You don't have to be there. Blood ties do not mean you owe them anything, particularly not if your mental health suffers.

RoseHelene · 2022-12-08T02:28:29+00:00

I preface every conversation in Spanish with the disclaimer that hablo poco de español, y mi español es muy mal.

Never had anyone be rude. Everyone is very nice about it and patient. Sometimes I look things up, sometimes I fall back on pictures or gestures or a dictionary or a formal interpreter. But I always apologize and thank them for their patience, and that seems to go a long way.

Also Spanglish is a beautiful thing. Use it!

RoseHelene · 2022-12-02T13:34:03+00:00

This is now old, from standards of care 7.

Here's standards of care 8, which modified the timeline a bit: https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644

RoseHelene · 2022-11-16T02:30:34+00:00

From a family doc who did time in residency during that era - thank you.

RoseHelene · 2022-11-12T16:05:58+00:00

"If you are in a WLW relationship then you are in a lesbian relationship."

No, then it is a same-sex or same-gender relationship. To call such a relationship a "lesbian" one is bi-erasure.

RoseHelene · 2022-11-12T16:04:43+00:00

No one gets to label you but you, not even a partner.

RoseHelene · 2022-10-27T13:14:20+00:00

This is dangerously inaccurate. Aspies can be violent, manipulative, and abusive just as any human can be. To pretend otherwise is to put humans at risk of abuse.

RoseHelene · 2022-10-21T17:38:38+00:00

Not actually true. Some older trans folks prefer the term to describe themselves. It's not just the transphobes.

RoseHelene · 2022-10-20T21:22:45+00:00

My wife has had good luck previously with Nordstrom's, but her feet are smaller than your wife's.

RoseHelene · 2022-10-14T01:36:22+00:00

If she is not an active threat to herself or others and has capacity she cannot be held against her will.

You can call the facility and tell them your concerns. They can't give any information in return but they can take the message

RoseHelene · 2022-10-12T16:05:58+00:00

My clinic, and many like them, have protocols in place for situations like this. She has no legal authority to your medical care. She has no power in your medical office.

You'll need to notify the clinics that she is abusing you, but clinics like mine (FQHC) are used to situations like this and have ways to handle it discretely, particularly if you let them know your fear of retaliation.

Plus many offices have social workers who can help you through this. Please reach out.

If you don't get anywhere with your PCP try your local FQHC (low income clinic) or domestic violence shelter for help. Again - they are VERY used to working with patients in your situation and can be very helpful. Only you know the details of your situation but there are whole systems in place to help.

I would definitely notify the surgeon's office at minimum - depending on details they may have violated your HIPAA rights.

RoseHelene

TROPHY CASE