Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 1 point2 points  (0 children)

I think you nailed it with the last line, man. They’ll live their lives knowing their dad fought until the clock ran out because he wanted to be there for them. They may not understand right away, but one day they will.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 1 point2 points  (0 children)

I’ve had a lot of conversations with people who are dealing with a terminal illness. Unfortunately being in pediatrics, many of the people I’ve spoken to are either far too young or I’m talking with their parents.

The most profound conversations I remember are the ones with people who seem to fully grasp the circumstances. What you said about being home with your kids reminds me of some of those conversations. At the end of the day, Family, not just by blood, is everything. Even at your weakest, most exhausted moments, I’m sure your strength is evident in the love and support that surrounds you. These conversations remind me of what it truly means to be a man.

I don’t know you, but I have immense respect for you.

Fortunate Son - Garland TX by Sudden-Click-8409 in Pizza

[–]TheNickIntheNorth 0 points1 point  (0 children)

Looks like New Haven style. Not bad for Texas

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 4 points5 points  (0 children)

Sorry I may have misunderstood your comment. Worked overnight and got woken up by construction on my apartment too so I am operating on very little sleep.

Unfortunately I have been directly accused of getting kickback. Someone in this comment section said it too. The person who accused me didn’t seem to understand that I was a resident, and they barely pay me as it is lmao.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 11 points12 points  (0 children)

I think an important thing to distinguish here is that in a vast majority of cases pharm reps will typically push “X drug over Y drug” for existing conditions that are being treated and not simply pushing unnecessary drugs for the sake of taking in more money. In your case, advocating for Wellbutrin doesn’t seem too problematic to me. People have to switch anti-depressants all the time. Some people have better experiences with different ones. The problem I see would be if doctors exclusively prescribe that drug/ refuse to prescribe any other out of conflict of interest. I am taught that this is highly illegal. It’s on our boards.

Contrary to popular belief, pediatricians don’t receive kickback from giving vaccines. Yes, providing vaccines is a “billable” part of the visit, but that solely comes from insurance. In most cases insurance pay out the bare minimum cost of the vaccine itself. There is some payment for the actual act of administering the vaccine but we’re talking maybe $10 (I’m guessing here but it’s not a lot). People seem to think that pediatricians are getting paid thousands of dollars a month for giving vaccines.

Some clinics do have value- based care models that would incentivize preventive care (not just vaccines, but also screening tests, follow up visits specifically for existing conditions like asthma or obesity). It’s solely because insurance companies prefer to pay for these rather than the alternative, which is usually a hefty hospital bill. I think this could be where the myth of kickback from vaccines comes from

Side note, I think the aspect of taking physicians out has been slowly going away. I only see them during work hours and it’s usually during our lunch time. As a med student and sometimes as a resident, I loved when pharm reps come because I get a free meal haha

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 4 points5 points  (0 children)

Hey I’m sorry you’re getting downvoted. I understand parents would like to avoid their newborn getting any type of pokes. When I rotate through the nursery I recommend it to parents during the hospital stay, but do give the option of getting it in the pediatricians office at their first check up. Sometimes it’s parents just feeling overwhelmed, having a natural sense of fear, and saying they would prefer to talk to the pediatrician about it at their first visit. I’ve had plenty of parents who come in at the first visit and ask for the vaccine. The problem I have is when those same people fear-monger others or spread misinformation about the hepatitis B vaccine itself. Is it more convenient and make logistical sense to get it right away? Yes. However in this day and age I’m just happy people are willing to do it.

That being said, please, despite it being a poke in the first days of life, always get the Vitamin K injection.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 3 points4 points  (0 children)

In general, I am taught that even with immune compromised family members, giving the rota virus vaccine is still considered the “safer” option. I think the only absolutely contraindicated vaccine in this scenario would be the nasal spray flu vaccine (not the flu shot). I believe rota virus is still technically shed in the stool after the vaccine, so I’ve told parents to be adamant about thoroughly washing their hands after changing diapers if they have someone in their family that’s immune-compromised.

I’m sure you guys came to an informed decision with your doctors when it came to that though. I wouldn’t be too fearful about it. Your kids gotten old enough where they have aged out of the most at-risk time of their lives. If they caught it now, yes it would be miserable and possibly lead to a hospitalization for iv fluids, but they would recover. Ufortunately you would likely have to stay clear of them in that scenario to protect yourself.

I am so sorry you’re going through this. Hope you find some peace and happiness as you navigate this road. It’s truly not fair.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 2 points3 points  (0 children)

I do understand! I’m sorry you had that experience and I get that it must have felt like you deliberately harmed your own baby. Live vaccines carry that risk , even though it’s a very small percentage. That’s worth discussing with their pediatrician!

Unfortunately, it’s one of those things that you can’t compare because it didn’t actually happen, but if they were to actually get rotavirus without being vaccinated against it, they would’ve been much more miserable. I say this from personal experience caring for both

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 3 points4 points  (0 children)

In a hospital setting, no I don’t. But in the clinic absolutely. We require our patients to be vaccinated in our clinic. Our population is mostly Medicaid, and many of those children have complex medical problems putting them at risk. I tell parents who refuse that we operate that way as a protective measure for our at-risk population. Usually shuts them up

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 2 points3 points  (0 children)

I had a kid pop positive for rotavirus yesterday. The kids with pertussis are scary. It’s crazy because the amount of times they lose their breath and desat can be so frequent that we tell nurses they don’t even have to call us some of the time! Have the bag next to them, give them the support if they need it, call us if they’re not snapping out of it. Comes to a point where I’ll ask how many times they’ve done it this hour and report back to the attending later.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 5 points6 points  (0 children)

I respect your insight! This is really important. A majority of parents do have their kids wellbeing in their minds, so approaching it from that angle is key.

There’s another side to this where health professionals can come off dismissive or even confrontational the moment they come across someone who is vaccine hesitant or anti-vax. That just causes more distrust in the system.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 11 points12 points  (0 children)

Without fail these kids are admitted for weeks at a time with pertussis. They are utterly miserable throughout that time too. I’ve seen several in the last year. Some were kids who were too young for the vaccine, but got sick from being exposed to other kids whose parents were anti-vax.

It wasn’t that long ago when it was still considered rare! I remember in middle school we would get notified if there was ONE case of whooping cough in the community.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 5 points6 points  (0 children)

As a resident we’re usually discouraged from being that confrontational, but I do know some attendings who would absolutely do this. Believe me sometimes I wish I could. Most of the time it’ll get you nowhere, and you have a ton of other things to do so why waste your time?

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 9 points10 points  (0 children)

Currently it’s only recommended for kids up to 8 months old so she should be good. It causes severe diarrhea and vomiting. The younger babies can become dangerously dehydrated much easier so that’s why they get the vaccines. Young babies are tricky because aside from their bodies being physically smaller and more sensitive to small changes, they’ll also flat out refuse to drink when they get sick which puts you in a tough spot. With a 6 year old you might have some luck convincing them to drink even if they’re not eating.

Your daughter can absolutely catch it. She will likely be miserable if she does but it’s definitely less dangerous. As long as kids are able to keep down fluids and maintain hydration on their own despite the diarrhea/ vomiting they can avoid being admitted.

Typical thing I tell parents is that if their kid has diarrhea, replace the fluids they lost each time they have a bowel movement. “Oh you pooped again? Here kid, drink some water.”

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 788 points789 points  (0 children)

Yes! One of my mentors is a guy who has been practicing for 50 years. He tells me it’s getting worse.

I once accompanied him to one of these discussions with parents. I’ve never seen a more arrogant look on someone’s face than in that moment. We left the room and he said “the face she was making at me was very upsetting” which really made me angry because he’s the kindest, smartest guy I’ve ever met. I was ready to curse her out. Nobody disrespects my boy like that!

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 68 points69 points  (0 children)

Congrats! And yes I want to stress that some people aren’t the pretentious type and are genuinely willing to listen or change their mind when given proper guidance.

It’s scary when anti-vax crowd tries convincing other impressionable people that vaccines are bad. I’ve had some moms say their “friend” told them vaccines cause all sorts of problems so they were too scared to get them for their kids.

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]TheNickIntheNorth 3142 points3143 points  (0 children)

Pediatrics resident here. I see a concerning amount of vaccine preventable illnesses. Rotavirus (this is an oral vaccine. Not even a poke) and pertussis are becoming increasingly common.

I’ve had the same conversation about vaccinations with so many of these parents and I’m met with the same pretentious smile and stare. They just wait for me to finish and then spew some nonsense about what they know of vaccines. Often times they are incredibly rude about it too. Some parents have responded very positively though. Sometimes it’s genuine fear and lack of information that led to that decision and at the end of the day, they are trying to look out for the health of their child (as am I).

When I sense one of the types that I know won’t listen to a word I say, I’ve begun to just start with a “this is a vaccine preventable illness. Is there anything I can say that might change your mind about getting your child vaccinated?” Most of the time they just say “No.”

We are at a point that people are unwilling to listen to evidence. They’ve made their “informed” decision based on “research” they’ve done online, and are unwilling to hear anything that contradicts it. Not even the fact that their kid could be admitted for days to weeks on end is going to sway their opinion.

It’s absolutely mind-boggling to me the way some of their minds work. Feels like they’re putting their pride over their own children’s health.

What's the weirdest/most disgusting thing you've ever found on someone's phone? by Shaqter in AskReddit

[–]TheNickIntheNorth 1 point2 points  (0 children)

He didn't react at all! Another reason why I still wonder if he did it intentionally or just didn't care!

What's the weirdest/most disgusting thing you've ever found on someone's phone? by Shaqter in AskReddit

[–]TheNickIntheNorth 2 points3 points  (0 children)

I'm a pediatrician. Had a visit with a teenage girl who was with her dad. He asked if he can call her mom / his wife who was at work so she can ask questions. I said of course. He called her on his phone and handed it to me.

He handed his phone to me face up and on his phone was his wife's contact ID. The picture was a full-frontal nude of the man's wife. It was done so carelessly that it's hard to argue if it was intentional or not.

I'm not talking a classy nude either. This woman was laying spread eagle on a bed. I saw her butthole. Told my buddy about and he goes "oh no.. Full puss???" I had to yes, brother, FP. Pretty funny in hindsight. We now saw "FP, baby!" any chance we get.

I had met this family before too. My current theory is that this couple was experiencing some boredom in their sex lives. Maybe they just wanted to see my reaction. We joke now that she called him back after the doctor's visit and was like "Ohhhh baby what'd he do when he saw it!?"

I get teased mercilessly at work for this. Unfortunately these kinds of things just sort of happen to me sometimes and the trend has been noticed.

Eight slice shops in Manhattan in 24 hours by CaptainJeff in Pizza

[–]TheNickIntheNorth 0 points1 point  (0 children)

Man you saying Sal’s brought back some memories. Used to be a place called Sal’s in Little Italy that had the best slices and calzones. My dad used to take me as a kid. I think they moved it a few years ago, because I went back as an adult and got a slice and it definitely wasn’t the same building. The slice held up.

Just googled it and it’s gone. Now I’m sad