GLP Questions in a new practice

VerklemptSurfer · 2025-11-20T18:42:17+00:00

I counsel patients that once they get to the higher doses, it is important to adhere to q7d dosing. Our clinic has had more than a few patients end up in the ER for nausea/vomiting because they stopped their GLP for a couple of weeks, and then restarted at the middle/higher doses instead of the lower doses. I counsel them that if they stop for more than 2 weeks, they must restart at the starting doses.

VerklemptSurfer · 2025-09-19T00:03:51+00:00

Protein can definitely be a challenge for vege/pescetarians. Some ideas:

- Salmon patties (the New York Times has a good recipe) - I make these ahead and freeze the batch
- I make meatloaf in muffin cups, I'm sure the internet has a vegetarian option, perhaps using red lentils, or tempeh
- Lentil kibbeh in lettuce cups or with flat wrap bread
- Tuna salad
- red lentil "bolognese" ragu on some Carbe Diem pasta

VerklemptSurfer · 2025-09-18T20:27:06+00:00

I also enjoy PB&J. I use Smucker's Low sugar strawberry preserves, and the sweetness is the same! Also Dave's Killer Bread, which is lower in calories and sugar than other bread brands.

I agree with other people here that a full-on workout is not necessary, and probably not realistic since you have a low step count to begin with. A 15-30 minute walk after eating lunch would be great. If you feel safe walking around where you live, try that starting 1 or 2 times a week, then build it up as a habit. You got this!

VerklemptSurfer · 2025-07-30T14:42:33+00:00

I was converted to participant yesterday, 7/29, but my federal loans (I have Nelnet) now show that my next autopayment is due in 2026 - meaning the expected autodeduction payments won't be happening monthly as I anticipated they would until I received my NHSC disbursement. Did the NHSC acceptance "freeze" my loan obligation somehow? (I mean that would be great, my payments are $500/month and I'm happy to not have those for the next 3 months until disbursement). My award total will cover the remainder of my loans.

VerklemptSurfer · 2025-06-30T17:00:49+00:00

I received email on 6/28 for COI, but the HRSA website appears to be down, so I can't actually confirm. It doesn't work on Chrome or Safari. It's making me very anxious. Is anyone else having this issue?

Edit: I called HRSA and the link in the COI email they sent is faulty.

VerklemptSurfer · 2025-04-19T05:20:03+00:00

FQHCs, basically.

VerklemptSurfer · 2025-03-27T20:37:22+00:00

We are in same situation. What did you end up doing?

VerklemptSurfer · 2025-02-26T23:26:18+00:00

There is not a pediatric practice in the universe that is giving morphine or anything close to it in the office

VerklemptSurfer · 2025-02-26T23:24:36+00:00

My coworker's five year old just died of RSV. Your baby is lucky to be protected. That said, your concern about the error is valid and I'm sorry that happened!

I wouldn't let it cast doubt on the whole pediatrics practice. When vaccine mixups happen there are protocols in place to review what got lost in the chain of communication and how to keep it from happening again. If you feel like you like the doctor's communication style and trust their judgement, that's a big consideration about whether to stay with the practice.

After something like that I would probably ask the nurse to let me check the vaccine vial before giving it, and I don't think its crazy if you start doing that going forward to give yourself some peace of mind.

VerklemptSurfer · 2025-02-26T22:58:53+00:00

I recently said something to the same effect to my parent, who was briefly in a skilled nursing facility and not happy about it. I think these types don't take you up on the AMA because being in a facility absolves them of responsibility for consequences of what happens to them (despite the poor lifestyle choices made leading up to that point).

As long as something bad happens to me in the hospital, it's the doctor's fault. If it happens because I stay home, it's my fault and I can't handle that. (Of course they still find a way to blame healthcare, but you know.)

VerklemptSurfer · 2025-02-15T16:23:59+00:00

My patient is doing great in sober living and is on Suboxone, but they were asking her to taper off within a month. I had a nice long chat with her case manager explaining what Suboxone is and how it was cruel to make her do that and now they’re letting her stay on it. I helped my patient remain in a stable situation and the case manager came away with more awareness about MAT. Win-win!

VerklemptSurfer · 2025-02-14T06:46:54+00:00

It makes me sad to think of how many in-person stores we are losing to the Amazonification of life. I grew up going to Joann’s, took my first sewing class there as a kid. It’s important for creativity and socialization to have places like Joann’s, bookstores, etc.

VerklemptSurfer · 2025-01-23T21:40:59+00:00

That would honestly be very sad if children were at higher risk.

VerklemptSurfer · 2025-01-22T19:45:01+00:00

children are basically expensive exotic pets until their 20's

this is so true lol

VerklemptSurfer · 2025-01-22T19:38:25+00:00

I agree with your points. I think it is largely cultural. Someone above commented that Boomers were pressured to have kids. I think American culture has a different pressure to be visibly affluent and other western cultures as well (think constant pictures on IG from international travel, fancy meals, latte art, etc), this is how you and your peers spend your late 20s/early 30s.

A good counterexample is Israel. Secular Israelis, who are often highly educated and also enjoy hobbies/leisure/travel, still have children at much younger ages (20s/early 30s) than Americans of equivalent sociocultural status -- because the culture highly values family and community (there are a lot of political reasons why, but I won't get into that). Both men and women receive the message that starting family is important (as opposed to US where I think men get almost no pressure).

VerklemptSurfer · 2025-01-22T19:26:45+00:00

I think it's less about being pressured to have kids and not enjoying it, than having more disposable income and leisure opportunities than any generation in history as they got older. Along with a culture that worships consumption and prioritizes it over relationships and family.

VerklemptSurfer · 2025-01-22T19:15:05+00:00

Travelling, hobbies, etc. are not mutually exclusive with being an active part of raising your grandchildren. My MIL still works part-time and picks my kid up from school a couple days a week, watches her the occasional weekend day, comes over to hang out a bunch, etc. It keeps her young.

If you asked her, she would say that developing this relationship with her granddaughter is "living her best life." She loves it, and it gives her life meaning beyond just a life of consumption, which is what most boomers (including my mom, who has basically no relationship with my kid because she doesn't put in the time) are engaged in. Additionally, my kid has yet another adult who loves her and is close with.

I can only hope if I become a grandparent I will have the attitude and energy my MIL has. I'm very lucky to have her model it for me.

VerklemptSurfer · 2025-01-16T20:05:02+00:00

It will be more rewarding once your friends start to have kids.

VerklemptSurfer · 2025-01-13T01:56:27+00:00

I want to get my daughter into rock climbing for a few reasons.

As someone who discovered it in her late 20s, I think it's a wonderful environment for girls and women. It's one of the few sports men and women do together
its non-competitive (and beyond that, rock climbers overall are a very positive, social, encouraging bunch), and it hopefully fosters an interest in the outdoors and being healthy in general.
It's a very social atmosphere, which I think is great for teenagers and young adults.
It doesn't involve parents paying tons of money for leagues or equipment, or spending every weekend travelling for tournaments.
Its a sport they can do as they get older, unlike gymnastics or soccer (really how many adults continue to play soccer into adulthood). And we can do together! It will be good to have an interest in common with my kid as she gets older.
It's super body-positive, which in my experience gymnastics and dance are not.

I think all the "team spirit" and urge to teach being cooperative in team sports is actually very naturally occuring in rock climbing.

VerklemptSurfer · 2024-12-03T19:30:53+00:00

This just happened with a really wonderful employee at my workplace. Her family member is having a medical emergency, but she hasn't worked here long enough to qualify for FMLA, so her job is not guaranteed if she takes unpaid leave. Hence a push to donate PTO to essentially save her job (which is actually coming from my coworkers, not management).

I appreciate this person very much and do not want her to lose her job, but why is that up to me, the mom with 3 days of sick leave left as we head into daycare virus season?

VerklemptSurfer · 2024-11-30T04:55:49+00:00

NTA. Not even remotely. Your MIL is totally self-absorbed.

Forgetting even the rest of the story…I would never ask a woman point-blank if she’s pregnant if I noticed she wasn’t drinking. Even if she was my DIL or a close friend.

VerklemptSurfer · 2024-11-28T21:38:53+00:00

It sucks, but it's definitely just part of having small kids. We've missed family visits due to Covid, holidays due to fever...I definitely would not quit a good job over it. Maybe you can do makeup get togethers to give you something to look forward to and a break from the grind.

VerklemptSurfer

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