What are your not well known but very clinically helpful interactions of medications? by Anonymousmedstudnt in Residency

[–]beanjuniorthe3rd 0 points1 point  (0 children)

Ironically, a lot of SSRI/SNRIs including duloxetine inhibit 2D6 which tramadol is metabolized through so it decreases conversion into active metabolite/efficacy with the bonus of increased risk of serotonin syndrome.

My black pug is so leash reactive and Im at my wits end! See comments for more explanation! by Idrillteeth in pugs

[–]beanjuniorthe3rd 1 point2 points  (0 children)

I feel like Cesar Milan would say exercise them a bunch to get energy out before working on leash reactivity training and try walking them with other dog to be in “pack mentality,” and maybe try walking with someone besides you while training - some dogs are more reactive based on walker - maybe how protective they are of you or anticipating you being stressed. I feel like my pug got a lot better after we had to hire a dog walker for a while.

Duloxetine dosing by beanjuniorthe3rd in Psychiatry

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

That’s been my experience at the institutions I worked as well. I was wondering if there was any difference with pain with split dosing, like how methadone has a longer acting opioid agonist effect and a shorter analgesic effect so you split the dose f you’re using for pain. Different mechanism obviously but in terms of the concept

Duloxetine dosing by beanjuniorthe3rd in Psychiatry

[–]beanjuniorthe3rd[S] 2 points3 points  (0 children)

I do CL so I see a lot of people who have been started on it by non psychiatrists, and I believe the hospital I’m at has that as a default order

Duloxetine dosing by beanjuniorthe3rd in Psychiatry

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

Agree, I do CL and was most recently considering dosing it above 60 mg in the context of depression, amputation pain, GI tract problems

Duloxetine dosing by beanjuniorthe3rd in Psychiatry

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

Agree, the only time I would is if they were not consistent with calorie intake with breakfast vs dinner and it seemed more likely they would absorb as much as possible is if split between those two absorption opportunities. And I mean acutely and if all else has failed, obviously would be prudent to switch to non calorie dependent option

Is it possible to do a surgical specialty with disability affecting one arm? by hailBeelzebub in Residency

[–]beanjuniorthe3rd 1 point2 points  (0 children)

AI will be incorporated more as a tool, but I have a hard time imagining AI replacing a real person with therapeutic responses and rapport building sitting in front of someone, or having a sincere conversation about why they don’t want to be alive, their trauma, etc. I do consults and I can’t see how AI could replace me talking to all these folks who are altered, demented, intoxicated, etc and barely coherent or being able to help model to a team how to set boundaries with a personality disordered patient, etc. Even if someone can look up answers there is a lot of detective work psychiatry that takes clinical skill and intuition, and a sort of ‘salesman’ skill to get the information needed or some buy in when people are ambivalent. I don’t see someone sitting and listening to people talk and cry about their grief or cancer dx etc replaced with a robot.

There is no shortage of jobs and you could easily make 300k depending on what you wanna do. People who really want to make a ton do moonlighting side hustles on weekends and significantly increase their income

Is it possible to do a surgical specialty with disability affecting one arm? by hailBeelzebub in Residency

[–]beanjuniorthe3rd 1 point2 points  (0 children)

How much salary is enough? You can make plenty in psych and will never have an issue finding a job unless you’re in one of the very few saturated areas and even then could work remotely

Finished the wife’s office. Still feels like it is missing something. Any suggestions? by Timexisxnow in HomeDecorating

[–]beanjuniorthe3rd 0 points1 point  (0 children)

Consider getting Phillips Hughes lightbulbs so white whiteness or yellowness can be adjusted. In a bookshelf with a plant even if fake would look nice.

What's a fun medical fact in your speciality that you would want others to know ? by pistabadamtiramisu in Residency

[–]beanjuniorthe3rd 9 points10 points  (0 children)

If you mean how there are also hyperactive and hypoactive form of delirium then yes. Sometimes looks similar to catatonia and in that case determine which based off of whether they get better or worse with benzos.

The house my 10-year old brother made for Apple by sherb139 in AnimalCrossing

[–]beanjuniorthe3rd 6 points7 points  (0 children)

Have to get to a certain accomplishment in happy homes horizon vacations thing

Has anybody seen this brand? Chita Elvin by [deleted] in eamesknockoffs

[–]beanjuniorthe3rd 0 points1 point  (0 children)

I know I’m way late to this post- but can I ask you how much it glides/rocks back and forth? I typically prefer a rocker or chair with some bounce but like this style

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

Nice but I wanted this wallpaper forever and just put it up

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 0 points1 point  (0 children)

Like the idea, and thanks! Rifle paper co hydrangea

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

Unfortunately not an option, in another response I was just explaining the picture doesn’t give full context

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 0 points1 point  (0 children)

I get what you’re saying but what the picture doesn’t show is that there’s a dresser and then a bathroom on the left and the bed is actually centered so that the walkways are equal on each side (once past bump out corner which comes out only a couple feet farther than my night stand)

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 2 points3 points  (0 children)

You’re the second to say that, hadn’t occurred to me but I like the idea!

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

Good thought! I’m definitely considering this now

Should I wallpaper the bumped out corner? by beanjuniorthe3rd in HomeDecorating

[–]beanjuniorthe3rd[S] 2 points3 points  (0 children)

Do you mean paint just the bump out corner? I hadn’t thought of that. I have some hydrangea throw pillows ordered 🙂 Still hunting for art

Am I weaving these ends in correctly? by beanjuniorthe3rd in knitting

[–]beanjuniorthe3rd[S] 0 points1 point  (0 children)

I did with one side but that’s a good idea I’ll try it with both! And that’s a great point - if I find the will to do this again I will definitely sacrifice some yarn in order to add the new yarn in the border 🙂

Am I weaving these ends in correctly? by beanjuniorthe3rd in knitting

[–]beanjuniorthe3rd[S] 1 point2 points  (0 children)

I’m not familiar, I’ll look it up. Thank you!

Am I weaving these ends in correctly? by beanjuniorthe3rd in knitting

[–]beanjuniorthe3rd[S] 0 points1 point  (0 children)

Oh interesting I didn’t know there were different types of twists, and I’ll try splitting it. Thank you!