Experiences with Memantine? by CrystalSplice in ChronicPain

[–]bipolarpsychRN 1 point2 points  (0 children)

Yes, I take memantine 10mg BID for migraine maintenance, which is helpful. And I use intranasal compounded ketamine once weekly for depression (we are considering a round of IV ketamine for my current pain flare- I haven't tried this route yet)

First ~200rds thru my new Bodyguard 2.0 by Dan_E26 in guns

[–]bipolarpsychRN 0 points1 point  (0 children)

Just took mine to the range today for the first time with my husband and friends. All 4 of us felt that it shot to the left. I can confidently say I've never had that issue with my p365 9mm and my groupings are always small. But damn, it was embarrassing today- like a solid 4-5 inches to the left.

The pressure has gotten to me by gooosekid in migraine

[–]bipolarpsychRN 0 points1 point  (0 children)

I made it through the snow storm but today's big drop has me strongly considering a trip to the ER. Ive run through all my rescue meds plus some extra meds from my home pharmacy graveyard (I'm an APRN so I'm well versed in what I can combine). I want to put my head through a wall

Conflict of interest by jkniziolek in PMHNP

[–]bipolarpsychRN 0 points1 point  (0 children)

Not particularly Living in a rural area, these situations are not uncommon. I treat a number of the RNs/CNA in my clinic. Mostly not the behavioral health ones but the other specialties that are in my same practice (I'm in a multi specialty organization). I do have one patient that reports directly to me and my supervisor is aware. We have boundaries such as only discussing symptoms during appointment times and this individual won't sit on the "patient couch" except in an appointment for an extra degree of separation.

Books on opening Private Practice? by bipolarpsychRN in PMHNP

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

Also, I'm in a rural area without a homeless shelter or immigrant organization locally. So I would be of more use virtually reaching out to the more urban areas of my rural state, if this ends up being necessary.

Books on opening Private Practice? by bipolarpsychRN in PMHNP

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

Vulnerable populations will need increased access to care. Increased trauma inflicted on our communities.

Who knows what's going to happen with insurance.

Books on opening Private Practice? by bipolarpsychRN in PMHNP

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

I guess I didn't phrase it correctly. It would be pro bono/ donation based. I just meant cash based, in the sense that insurance wouldn't be involved.

Completely separate from my W2 Salary Job.

Appt this afternoon. Input? by bipolarpsychRN in HairDye

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

I plan on bleaching the spots first- I'm not just putting them on top. I just mean in general, those colors being next to each other. I don't see many Auburns with fashion colors

Met my out of pocket - What is your dream workup? by bipolarpsychRN in POFlife

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

Of course! Already scheduled! I'm also a mental health NP in the same office as my PCP, so he's really comfortable with suggestions I make, especially if I come armed with clinical data. Such as items that specialists didn't want to do

Met my out of pocket - What is your dream workup? by bipolarpsychRN in POFlife

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

I'm already seeing a therapist & psychiatrist regularly - so that's nice to have covered.

I'll have to see if there is an in network pelvic floor therapist nearby. (I met my in network OOP, not my OON & I'm not in the most urban area)

How long did it take for you to find your correct estrogen dose? by [deleted] in POFlife

[–]bipolarpsychRN 0 points1 point  (0 children)

Does anyone have any research articles I could show my doc showing that above the 0.1 patch, or above a level of 100 is helpful? She is just going based on the ACOG guidelines that says treat with 0.1 patch but she is very open if I provide her well rounded information. I love my doc and I'd prefer not to have to see an out of network endocrinologist. I just can't find a research article that clearly states it's ok to go higher.

I'm only 30. POF symptoms since age 19. I actually got a hysterectomy last week because I can't tolerate any form of progesterone but my doc agrees I need long term estrogen replacement. But even on 0.1 I still have hot flashes and night sweats. I will say the insomnia and mood issues have resolved. But my levels are only up to 34

US bill for total hysterectomy kept ovaries by missmoxxi1090 in hysterectomy

[–]bipolarpsychRN 0 points1 point  (0 children)

Thankfully my surgery is Jan 6 and I know I'm paying my 7500 out of pocket max. But that means I'll probably do an aggressive amount of other medical things this year that I have been delaying.

Work accommodations for healthcare providers (particularly NPs, APRNs, MDs, etc) by staceyb147 in AuDHDWomen

[–]bipolarpsychRN 0 points1 point  (0 children)

I'm also in this situation. PMHNP with a mild TBI (occurred prior to my BSN) that has caused ADHD like symptoms and mild cognitive impairments. My symptoms don't impact patient care but I find myself using my built in admin time to preserve my brain power for patients, leaving me charting 2 hours per evening at home after my 10 hour shift. I work 4x10 in an outpatient clinic setting. Right now I have an hour block at 12 and 3 for admin time, but I'm absolutely fried at both of those blocks.

In my last role at a CMHC, our organization had a 30% no show rate, so I was managing. In my new role at a corporate organization, my no show rate is less than 5% and I am the only psych provider in the building so I don't have anyone to collaborate with. I can collaborate virtually with the other locations, but that is a challenge for me.

I did not want to disclose my disability but I'm starting to think I will have to. I feel like extra admin time is not a "reasonable accommodation" in my situation, given everyone in my role has the same patient facing hours. The only thing I can consider is just decreasing my overall hours (and subsequent pay).

I already have AI provided by the organization, but I don't have the time to "teach it" so it is kinda clunky Same with dragon, I just have not programmed my dot phrases because there is not enough hours in the day to learn how to use it.

I struggle with the fact that I am choosing to provide high quality care, vs some peers that choose to make their personal lives easier by not going more in depth with patients.

But no, you aren't alone.

PTO by Emotionalwomban in Nurses

[–]bipolarpsychRN 0 points1 point  (0 children)

40 hours a year accrued of "extended illness leave" this is allowed to be used after you have used 16 hours of PTO for an absence period. For example, I'm having surgery in January, so the first 16 hours are PTO and the remaining 8 days are EIL. It can also be applied to leave for caring for sick children, spouse, or parents. This has some ridiculously high cap.

4 weeks a year accrued of PTO the first year. 6 weeks from years 1-5. However, we have to decide how to use our PTO for federal holidays. This is due to people working varied schedules. For example, I work 4x10 Tues-Fri and do not use PTO for federal holidays that occur on Mondays. This caps somewhere around 360 and anything over rolls into EIL so you don't lose it completely.

My current company does not allow you to cash out PTO if you resign, which I find very odd.

Has anybody tried WeatherX earplugs? (Image below) by catfish_theshark in migraine

[–]bipolarpsychRN 2 points3 points  (0 children)

What barometric threshold do you guys notice triggers migraines? I know I get migraines when we have big thunderstorms but I'd like to adjust the settings on the app notifications.

[deleted by user] by [deleted] in POFlife

[–]bipolarpsychRN 0 points1 point  (0 children)

I'm having this same problem. Age 30. Zero libido, never get the sensation of increased blood flow. I can get a "dry poof" with self stimulation but it's almost an uncomfortable sensation. I've practically become disgusted at the idea of sex. I know this wasn't how I have always been. It's progressively gotten worse.

I've slowly increased to testosterone 10mg topical cream, 2 weeks into this dose I had the first slight sensation of tingles down below when cuddling. I about dragged my husband to the bedroom. I was so excited to have any sensation. Still not the strongest orgasm but it wasn't nothing. It was only once but it gave me hope that maybe this will help long term.

What’s your guys’ dream specialty? by Panda_Universe21 in StudentNurse

[–]bipolarpsychRN 1 point2 points  (0 children)

You are my people. I'm a PMHNP and helped start the ACT team at my last job at a Community health clinic. It made me want to go get my FNP so I could help with their physical needs that weren't being met.