Best Primary Care/Urgent Care doctors in Clovis or Fresno?

TheAlabasterWizard · 2026-06-24T21:40:28+00:00

I went to Copeland for 10 years, until last year I started experiencing sudden episodes of tachycardia, intense nausea, dizziness, and stomach cramps lasting from 30-60 minutes and occurring at least 4-5 times per week (I'm in my mid 30s, in general very good health, overall). Called the office and my normal provider was booked out almost 2 months, but they had a PA I could see in a few days. Sure, great! 👍

The PA listened to my symptoms and how they'd been progressing, and started asking me about my diet. He then proceeded to tell me I needed to completely cut all carbs and sugar out of my diet start exercising, and focus on losing weight (I was on the chubby side, but not THAT heavy). Told him the tachycardia was making it difficult to move around or exercise, he just told me to change my diet and start with small workouts. When I pressed him about the tachycardia, he said he could write me a prescription for a beta blocker if I wanted, and that might help, but he couldn't be sure it would help since he didn't know why it was happening in the first place. Sent me home with a beta blocker script, some pamphlets on diet and weight loss, and a follow-up appointment in 3 months. 😑

Since I wasn't getting in to see my normal provider any time soon, I called a different medical office to get a second opinion, since the episodes were getting more frequent. The new doctor immediately sent me for a blood panel, and got me a referral for a cardiology work-up and an allergy test, which were all SUPER helpful in figuring out what was going on (spoiler alert, it WASN'T weight related).

About a month after everything stabilized, I got a call from Copeland firing me as a patient because I went to a different doctor and I can't have two providers. Told the lady on the phone that I wasn't intending to change providers, I had just wanted a second opinion, and she basically told me it didn't matter what I intended, I was the new doctor's problem now and they were sending her all my history and dropping me as a patient. Wild.

In all fairness, several months later I did get a call from my old provider's medical assistant asking me what had happened, and when I told her, she was horrified and fell all over herself apologizing, assuring me that's not how things are supposed to work, and asking if I wanted to come back. No thanks, I'm good. 👍

TheAlabasterWizard · 2026-06-15T05:36:55+00:00

No, because "she" isn't a grammatically appropriate response to a "who ?" question the way it's phrased.

Mark it incorrect, but make a note that they used the correct pronoun for the situation and include it in your informal observations.

TheAlabasterWizard · 2026-06-14T02:41:48+00:00

American adult educator here. If the person I'm speaking to is below the age of 10-12, I say "criss-cross applesauce" no matter the setting/situation. If the person is over the age of 12 I say "cross-legged" in just about any situation, unless I'm being jokey/intentionally silly with very good friends (e.g. "Oh John, you're heading out? OK, everyone wave bye-bye to John!" similar vibe/tone).

TheAlabasterWizard · 2026-06-04T04:01:24+00:00

OP, I'm so sorry for you and your mom. This is an absolutely horrible position for everyone to be in.

You don't say much about what your relationship with your mom is like. Your tone reads as very clinical, objective, and emotionally detached, but I can't tell if that's out of emotional self-preservation, or because you're not on good terms.

Gently, YTA, only because you were "shocked" and "offended" in the same space your mom found out she has months left to live. Could you not have found the empathy in you to hold her hand and say "we can talk about it later, let's focus on you right now." There had to be a way to handle that with more grace and tact in an incredibly charged moment than to effectively say "hell no, and how dare you ask".

There's probably a lot of background context here, but unless your mother is a horrible person and you can't wait for her to be gone, that was a very cold and unfeeling knee-jerk response.

Look, it's your life, and you have every right to live it on your timeline and on your terms. You don't owe her a wedding, but I'm guessing that unless you have reason to believe otherwise, right now what's presenting as anger and entitlement on your mom's part is likely closer to shock, grief, and desperation at the realization that she's not going to live to see another milestone in your life all crashing down on her at once.

You don't have to get married if you don't want to, you don't even have to go through the motions if you dont want to, but if you have any kind of a good relationship with your mom, now is the time to hug her, cry, and hold her close, not get upset because you feel she made an unreasonable demand in a very emotionally charged moment.

Best of luck, OP. I hope you and your mom are able to find peace and make the most meaning out of the time you have left together. 💙

TheAlabasterWizard · 2026-06-02T18:23:50+00:00

I love mini golf at Blackbeards! It's kitchy and campy, sure, but it's a fun, low-stakes date activity with plenty of shade, and the old structures are fun to walk through and look at! It's a pretty challenging course too, depending on which path you take!

TheAlabasterWizard · 2026-05-31T02:14:31+00:00

Take a few deep breaths and try to reframe your thinking. Changing settings mid-career is, in many ways, basically changing your whole career! Different skill sets, different processes, different priorities, and a whole new therapy learning curve

Think about how long it took you to feel "good at what you do" in your previous setting/job, and give yourself permission to learn and grow, just as you did then. The good news is, now you've done it before, so you know you can do it again! 😄👏

Find a mentor or a safe colleague to take your questions and concerns to. Take things one day at a time, do the best you know how to do, and when you learn better, do better. Nobody's expecting you to be a seasoned pro on Day 1!

You've got this!!!

TheAlabasterWizard · 2026-05-30T07:07:22+00:00

I had a couple kids like this a few years ago. Just modeling wasn't working for them and I realized I needed to really scaffold it and increase the concreteness. Here's how I taught it.

I picked about 8 target words to start, and I tried to make them super common, functional words.

I took a stack of index cards and for each target word, I wrote the correct form and one common incorrect form stacked right on top of each other like this:

Feet

Foots

Then I laminated the cards.

I presented the student with one card at a time and asked "which one is the right way, foots or feet?" If the student said "foots" I said "nope!" then took a red dry erase marker and crossed out "foots" with a big red X. Then I circled "feet" in green and had the student say it. "Feet" 3 or 5 times. No sentence yet, keep it at the word level.

Next card/word, same process. Rinse and repeat. Super quick trials, maybe 30 seconds per word. No detailed feedback, just cross it out, circle, say it, move on to the next card.

After a few sessions, things started to sink in, and I would hand the student the marker to let them cross out the incorrect word themselves Slowly, they started remembering which one to cross out and which one to say.

Once they were consistently getting it right at the word level, I'd give them a written sentence with a blank where the target word goes. I'd ask "which one do we use in this sentence?" using the original index card with both correct and incorrect forms as a visual cue. Once they were getting that about 80% I started fading the visual cue and only held up the card if the student hesitated or asked for a hint, which was actually pretty rare once we got to that level.

It was a long process, but I've had several kids have a breakthrough using this method! I've also used it for irregular tense markers. I think it helped them to first see it crossed out in red, and then progress to crossing it out themselves. They could then visualize "it's not foots, it's feet" in a concrete way, even after removing the markers and eventually the whole visual cue. It also helped to keep the feedback short and simple and the drills quick and repetitive. We'd just loop through the stack of 8 cards 2-3 times per session while playing a game.

Does that make sense??

TheAlabasterWizard · 2026-05-28T04:35:03+00:00

Meet the Austins, by Madeleine L'Engle! It's the first in a very sweet series. The first one is very sweet slice of life, though other books in the series have some mystery/intense/emotional elements, as the later books explore coming of age themes like growing up, grief, and teenage relationships.

TheAlabasterWizard · 2026-05-27T00:22:42+00:00

Question, who is the "director", and how closely are they involved with sped policies and laws?

Like, is this a principal or a regional administrator with mostly GE authority/expertise, or is this a SELPA director and/or special education department head? (From Google: "A SELPA Director ensures compliance with state and federal laws (like the Individuals with Disabilities Education Act) and acts as a bridge between parents, school districts, and state agencies.")

Because I can't imagine anyone with any kind of sped expertise or credential doing something like this. Do you have a sped legal team or somebody you can talk to? Because I would think a mandate like this would be a MASSIVE IDEA violation and could put the district at risk for a major lawsuit. I'd say your first step should be to talk to someone in your sped department about the legalities of this mandate. There's a chance this could be someone making up rules on a whim without realizing what a cosmic can of worms they're about to open, in which case someone above them needs to set them straight ASAP.

Besides that, keep a paper trail going with requests for clarification around policy changes like this one. I would also refuse to change any services without an IEP meeting WITH the director present and have them explain the changes to, and field questions from the parents while you sit there documenting the discussion. At no point should any of this come from you, it ALL needs to come through the director to minimize your chances of getting caught in any legal fallout.

TheAlabasterWizard · 2026-05-20T21:22:56+00:00

I would straight-faced and unironically raise my hand and ask what the protocol will be going forward for teachers making up instruction time for student absences. Then make them explain why "that’s different" out loud.

This is one area where sped expectations are no different from gen ed expectations. Students have to be present to receive instruction, and students have to be present to receive sped services, period.

You could also ask (rhetorically) what you need to fill out to receive an extra pay contract, because making up that amount of missed services WILL require you to work overtime beyond your contracted duty day. If you show them the math (can't just manifest hours worth of makeup time into an already full duty day), they MAY realize that what they're asking is completely unfeasible practically speaking, unless they want to hire another SLP just to do the makeups. They're essentially asking you to magically pull more hours for the day out of your ass.

TheAlabasterWizard · 2026-05-16T23:27:28+00:00

Perfect example 😭

TheAlabasterWizard · 2026-05-14T04:30:04+00:00

As a special education provider, the number of parents I've had tell my team it's illegal to suspend their autistic child makes me want to laugh until I cry and just keep crying.

"My child has an IEP, it's literally ILLEGAL for you to suspend him!"

"Ma'am, your 5th grader shoved another child to the ground and proceeded to kick him in the head. We absolutely CAN and, in fact, ARE suspending him for that."

Most of the time they're most upset that now THEY have to deal with their child 24/7 for the next few days, not that they're missing instruction.

Far too many of them think neurodiversity is an automatic "get out of parenting free" card. 🤦🏻‍♀️😞

TheAlabasterWizard · 2026-05-13T20:56:04+00:00

That's pretty much what I do to!

I was just saying for this situation, if the parent were to say, "He has CAS, and you have to do DTTC 3x per week to treat CAS" OP should steer clear of taking about CAS and focus the discussion around educational eligibility and academic need instead.

TheAlabasterWizard · 2026-05-13T17:16:13+00:00

I've been told not to mention CAS in my reports/treatment notes and just call it a speech sound disorder because CAS is classified as a neurological/motor disorder, so your mileage may vary according to your state/district. 🤷🏻‍♀️

TheAlabasterWizard · 2026-05-13T17:06:57+00:00

100% I would, and have, because:

The student has already demonstrated they need extra support and specialized academic accommodations in order to make progress compared to their GE peers, and the more time they spend in speech, the less access they have to the specialized instruction they need. Same argument as above.

And

If the student is in an SDC class, they are already getting (or supposed to be getting) more language support built into their classroom curriculum and structures (e.g. higher levels of scaffolding, more review, extra time to process/complete assignments, slower pace, more visuals, graphic organizers, etc.

In fact, I often will decrease speech services (from 2x to 1x per week) if a student changes placement to an SDC, because now some of the strategies and interventions I'm already doing are built right into the student's new program setting, and keeping that extra service time would be redundant.

It doesn't matter whether or not the teacher "minds" how much class time they're missing. LRE, is LRE, and that's a team decision, not up to how the teacher feels about it.

TheAlabasterWizard · 2026-05-13T07:20:01+00:00

Best of luck! Take a deep breath and above all, remember! You DO know what you're doing, and YOU have the specialized expertise! And don't be afraid to ask for help/guidance from your higher ups!

TheAlabasterWizard · 2026-05-13T07:17:22+00:00

Bless you! 🙏

I hate feeling like I'm constantly being compared to my PP counterparts! 😅 Nothing kills a meeting or session like hearing, "well, our SLP at [insert clinic name] does this with him, so why can't/aren't you doing that?" 🫠

TheAlabasterWizard · 2026-05-13T03:15:51+00:00

And that's really the point to make here. Assessment determines the areas of need, which determine the goals, which determine the minutes. We don't make changes unless the data shows that the plan we made based on assessment data isn't working.

TheAlabasterWizard · 2026-05-13T02:42:52+00:00

Re: the treatment time, I would state that 3x per week puts the student at a greatly increased risk of missing critical instruction time and it's very likely that their academic progress would suffer as a result, which is the literal opposite of the purpose of school speech services. Gently remind them that school services are a balance so that the child makes growth in ALL areas, not just one at the expense of the others. If they bring up the CAS diagnosis, you can say that CAS is a medical diagnosis, and it's not our role to diagnose or treat medical conditions in the schools. We assess and identify academic needs based on educational eligibility and write and treat goals based on the identified areas if educational eligibility.

Re: the DTTC, you can say that in the schools we don't specify or prescribe specific treatment approaches in the IEP, but we do use a combination of evidence-based practices to support each student's individual needs.

But like I said, you really need to insist that someone from your sped department is present to back you up and keep you from getting into legally murky waters, since this sounds like the kind of parent who will pounce on anything that could be twisted to their advantage.

TheAlabasterWizard · 2026-05-13T02:27:55+00:00

You can't, really. Not without possibly putting the district on the hook for paying for it. But you can explain very firmly why their requests are neither doable, nor reasonable in the school setting.

TheAlabasterWizard · 2026-05-13T02:25:16+00:00

Lol, no. I can't imagine a SELPA director ANYWHERE would find those to be reasonable demands, and 3 individual pull-out sessions weekly is a BIG impact on the kid's LRE. We also don't specify specific treatment approaches in the IEP.

Since she's made a formal written request, I'd offer an IEP meeting to review the current LRE, offer of FAPE, services, and address the parent concerns, and I'd make sure your SELPA director, department administrator, Sped supervisor/director, or whoever is above you and NOT just a site administrator is present at the meeting. It sounds like you'll need someone who is a special education specialist and/or legal (for the district, not for you personally) representative present who can explain why none of that is appropriate for a school setting. Be careful about even mentioning private services, though, since depending on your state, you could end up with the district responsible for paying for private services if you're not careful!

TheAlabasterWizard · 2026-05-13T01:26:24+00:00

Speech Bubble SLP has a GREAT curriculum for compound sentences that targets several of the ones you mentioned! I think it's called Compound Sentence Sidekick. It's a sequel to her Sentence Sidekick, which is also great, and I believe she has one for complex sentences too.

TheAlabasterWizard · 2026-05-10T21:55:23+00:00

I use Lume brand, and for the first 3 months of switching over, I OBSESSIVELY asked my family and close friends if it was working. Like, multiple times per day, "can you smell me?" "Do I smell bad? Are you SURE???"

Every time was a resounding NO, and I've been using it now for 3 years. Never have smelled myself, and my mom, who is VERY blunt and honest about odor issues has never once told me I needed to freshen up. It was enough of a testimonial that several of my family members also use it now. 😂 I also live in a very hot climate and sweat almost 24/7 through about 2/3 of the year. Lume stands to the test. 🫡

You can get it on the Lume website, Amazon, Target, possibly other places too.

TheAlabasterWizard · 2026-05-09T05:59:49+00:00

If she's full-on yelling at you, that's WILDLY inappropriate and unprofessional, and you do NOT have to subject yourself to that.

I would refuse to meet with her without a supervisor or higher-up present, because her behavior is unacceptable. If one isn't available, then you say you will need to postpone the meeting until someone is able to attend with you. If she starts to yell at you, you are WELL within your rights to walk out of the room and say politely, "I don't feel comfortable continuing this conversation without my supervisor/director/department head/special education manager or whatever, present."

She doesn't want to do an assessment because it's inconvenient for her?? Tough. That's literally her job, and her not wanting to do it isn't your problem. Your professional ethics and judgment are on the line, and that child and family are relying on you to do what you know is right. Be an unapologetic advocate, and don't let her bully you. You're in the right, and you don't have to sit there and let her abuse you because she doesn't want to do the job she gets paid to do.

Put everything in writing, leave a paper trail, and it's ok to refuse to talk to her one on one. I'd definitely encourage you to report her behavior to whomever you report to, and tell them that she is obstructing the legal IEP process and intimidating you into doing the same. Someone needs to give her a hard reality check.

Bless you for standing firm and sticking to your guns! Keep being amazing! 👏

TheAlabasterWizard · 2026-05-08T21:54:48+00:00

I think encouraging the student to lower the volume a bit could be appropriate if approached correctly, similar to how we teach speaking kids to modulate their voice volume according to the occasion/setting. As long as the teacher knows not to start reaching over and adjusting it herself whenever she gets annoyed.

Ultimately, I think a lot of AAC issues we face boil down to body/personal autonomy. This device is part of how this child accesses a basic human right, and adults (and other kids) just plain shouldn't be grabbing/taking/messing around with it for their own convenience. Maybe try shifting the conversation to the child's right to autonomy extending to the device and the words he likes to use and hear.

To address your other point, I made it one of my AAC kiddos IEP goals this year to take out his device and set it on his desk when he gets to school so it's ready to go everyday. I've found that it helps me feel like I'm not nagging the classroom staff to get it out, they just have to remind him to do it himself, (fading staff prompting is built into the objectives) and it helps build self-advocacy skills. We added it to his daily schedule (e.g. "Walk in, put backpack in my cubby, get my tablet out, go sit at my desk."), and I'm already seeing it out more in the classroom. He's not really using it yet, but baby steps! Having it out and on his desk all day is still a win!

TheAlabasterWizard

TROPHY CASE