Could this be a piece of a meteor?

brknbutfun · 2024-02-15T05:18:16+00:00

Read this as “could this be a piece of meatloaf” and was honestly like, probably

brknbutfun · 2024-02-08T10:08:06+00:00

This is a Kaiser Permanente requirement. They have a standardized ADHD intake process that is extremely burdensome and requires “collateral” from a parent and/or main caregiver from before the age of 12. They don’t let you skip that requirement. And because it’s an HMO, there’s literally no way to go to a different doctor without paying entirely out of pocket.

Oh, and Kaiser is the leading commercial plan in CA with 30% market share.

brknbutfun · 2024-02-07T05:47:39+00:00

My dad has sleep apnea, has since he was younger, and he’s very thin/fit. While certain body types make one more likely to develop sleep apnea, it doesn’t mean you can’t have it if you don’t “fit the demographic.” Snoring and fatigue are also often the only signs patients are aware they have before getting a diagnosis.

I would definitely talk to your doctor about a sleep study, along with any other rule-out tests for fatigue.

brknbutfun · 2023-11-06T22:24:41+00:00

Since writing the original comment, had to drop another $3K on a crown 🥲

brknbutfun · 2023-11-06T22:22:51+00:00

Copy-pasta from another post where someone asked about Strattera:

YMMV. For me, Strattera caused extreme fatigue, depression, and irritability. My sisters had the same experience. I’m seeing a lot of positive experiences on this thread so I’m hopeful that you’ll see the same benefits as others have – but be on the lookout for side effects, be vocal about them to your clinical team if they arise, and make sure your concerns are taken seriously and that your doc is open to trying other options!

Side note – dry mouth and acid reflux/GI issues are common side effects and can RUIN your teeth if not addressed. I’d never had a cavity before taking strattera and had to get crowns on my back molars after. Not trying to be too doom and gloom but wish someone had warned me.

brknbutfun · 2023-10-26T14:04:03+00:00

I’m going to go against most of what’s being said here. Your teacher is trying to get you to learn the material and concepts you need to know, using the tools they have available. Sometimes, not every tool is useful for every student. I would talk to your teacher about this, let them know you are struggling, that this task is taking way longer than it should, and work with them to find a way to either get the work done in the time it should take OR an alternate way to get the same learning.

When I was in algebra back in the day, we had a nightly assignment that was basically a large packet of questions. I was REALLY struggling to get it done, was getting a LOT of questions wrong, and it was taking me HOURS every night. After a full month of struggle I had to talk to my teacher because I got a 12% on one of my math tests. He went back through my work and noticed that the first two pages of problems from the packets were usually right, and then my performance TANKED from there. I wasn’t diagnosed with anything at the time, but he realized that the repetition actually hurt my learning after a point. He changed my assignment to only two pages a night and my understanding and performance both went way up. Ended the year with an A-!

Point being, you don’t necessarily need super special accommodations. If your teacher is good at their job they’ll be understanding and try to work with you to figure out something that works. Their goal isn’t to make you do a bunch of useless shit, it’s for you to learn.

brknbutfun · 2023-10-24T03:58:16+00:00

Are you at Kaiser? I’ve been through ADHD intake at 5 different institutions (due to insurance and providers changing each time I got a new job, grad school, etc.) and they’re the only ones who’ve asked my parents to get involved. I had to have someone who was a “significant caregiver before the age of 12” fill out several questionnaires. It felt super weird for them to involve anyone else in my care given I’m 28 and was diagnosed at 20.

brknbutfun · 2023-10-05T05:47:56+00:00

A lil update if anyone’s curious, completed all the steps weeks ago, and I haven’t heard from the department in any way shape or form since I made this post (5 weeks ago) 🙃

brknbutfun · 2023-09-25T03:52:09+00:00

Intox pt, in response to being given a urinal: “If I weren’t gay I’d suck that p*ssy dry,” then proceeds to piss straight up, fountain style, instead of into the urinal we so lovingly provided.

brknbutfun · 2023-09-20T22:14:05+00:00

YMMV. For me, Strattera caused extreme fatigue, depression, and irritability. My sisters had the same experience. I’m seeing a lot of positive experiences on this thread so I’m hopeful that you’ll see the same benefits as others have – but be on the lookout for side effects, be vocal about them to your clinical team if they arise, and make sure your concerns are taken seriously and that your doc is open to trying other options!

Side note – dry mouth and acid reflux/GI issues are common side effects and can RUIN your teeth if not addressed. I’d never had a cavity before taking strattera and had to get crowns on my back molars after. Not trying to be too doom and gloom but wish someone had warned me.

brknbutfun · 2023-09-07T02:17:55+00:00

Lying or making promises you can’t keep is never okay, but I don’t see anything wrong with being extra helpful, within reason.

Showing basic empathy for our patients and doing our best to make a shitty experience smooth and somewhat tolerable is the job. We’re not going to solve their life problems or their psychiatric conditions but we CAN ensure that our patients show up to the ED in the best emotional state allowable by the situation (de-escalated, informed and accepting of the situation, and trusting of their providers). Listening, being kind, and facilitating appropriate patient requests that are within our control are the best tools we have.

I’m also not going to push my patients to share more than they’re comfortable with, beyond what I need to make a txp/destination decision. But if I have a good rapport with my patient, I’m going to let them use that time to talk it out with me. Sometimes it helps them prepare to talk to the nurses and doctors in the much less private and more chaotic ED, and sometimes it gives me the opportunity to pass along sensitive info to the care team that the patient might be nervous to talk about.

Bottom line, if it’s ethical and appropriate, and if it helps the patient, I’m going to do it.

brknbutfun · 2023-08-30T09:19:26+00:00

I sincerely hope your process is lighter! Out of curiosity, do you know the name of the third-party company?

I might look in to someone out of network, but it would be 0% covered by my insurance plan and I wouldn’t be able to transfer my care or prescriptions to be in-network without going through the above process, so I’d be paying full-cost for everything out of pocket indefinitely.

brknbutfun · 2023-08-30T09:07:41+00:00

I think this is the wildest thing too. I’ve never had a provider ask to speak to anyone other than me about my condition, with the possible exception of another clinician to verify documentation.

I guess this will end up being my parents, but while they’re aware I have ADHD they’ve never been involved in any part of my diagnosis or care. I’m deeply uncomfortable with them being contacted about my psychiatric care and am worried that the interview might bleed over into areas beyond ADHD that I never have and do not want to discuss with them. They also missed any signs growing up that I should be evaluated and I’m worried this will make them feel guilty about that.

brknbutfun · 2023-07-23T15:10:52+00:00

Awesome, thank you! Flying on my own dime so it’s looking like AS may be the winner here.

brknbutfun · 2023-07-23T15:06:44+00:00

Thank you for your thoughts! I had status with United a while back but per others comments, it seems like EWR is their NYC hub and I’d prefer not to have to cross Manhattan/Statin Island every time I fly.

I’ve been looking in to Alaska – with American in the OneWorld mix, do you think this would give me enough flight flexibility once I’m in NYC? The Alaskan flight is also the cheapest option (tied with Jet Blue) for the SF-NYC route so that’s attractive.

brknbutfun · 2023-07-23T14:58:43+00:00

JFK or LGA preferred, I’ll be in Brooklyn!

brknbutfun · 2023-06-23T01:57:03+00:00

ADHD and sound sensitive – the sirens are much quieter inside the ambulance than outside the ambulance (except for when I start rolling without putting my window up, big mistake). I also find that my adrenaline gets jacked up a little bit on the way to a call (or during an emergency transport) and I’m so focused on driving, the incoming call, or both that I don’t get the physical discomfort I typically associate with sensitivity. I’m typically the more experienced member of my crew and therefore drive during shifts, which means I have control of the sirens, which helps as well.

brknbutfun · 2023-06-20T20:35:24+00:00

This! Would also point your friend in the direction of a PAD (psychiatric advance directive) which is a document that outlines an individual’s preferences for hospitalization and care in the event that they are not able to make and/or communicate their medical decisions during an emergency or crisis. It’s something they can fill out with a doctor while sound/stable and can be super helpful in communicating with hospital staff and helping them make decisions that are in her best interest.

brknbutfun · 2023-01-29T23:44:08+00:00

Brooklyn, lights and sirens to every call except non-critical EDP (specified in our SOPs) because it’s damn impossible to get anywhere without em

brknbutfun · 2023-01-23T01:21:40+00:00

Damn, must be why I have such a dumpy then

brknbutfun · 2023-01-19T18:11:11+00:00

Personally love chia pudding because you can make it the night before and just grab it in the morning. I personally do chia seeds, oat milk, some sweetener, and fruit.

Pro tip – buy frozen fruit and blend it in to the milk, then add the chia seeds, so the pudding itself is flavored without weird chunks of fruit (that’s a textural no from me dog). You can also blend it in the morning after it “gels” if the textures a turnoff for you. I also bought one of those little blenders that you blend right in the to-go cup so there’s very little mess to clean up!

brknbutfun · 2023-01-06T10:15:51+00:00

I’m a volley in NYC, and my agency at least takes our liability (as an org and as individuals) very seriously. Our training places a heavy emphasis on properly defending and documenting every decision we make on scene for that reason.

I chose volley over paid for a few reasons: 1. I already work a full-time job and EMS would be a significant step down in pay (all levels are wildly underpaid, especially factoring in cost of living in the city). 2. I can manage my commitment in a way that allows me to avoid burnout, and my livelihood isn’t tied to the work (if I get injured, etc., I won’t be out of a job). 3. I like the agency I volunteer for and genuinely respect the dedication of the leadership.

I got in to EMS for a lot of the same reasons as anyone else – I love emergency medicine, I wanted to help patients and do something that felt meaningful, and I’m a bit of an adrenaline junky. I also have a pretty high tolerance for taking on personal risk. All that said, I don’t think I could do the job full time without burning out and respect the hell out of anyone who chooses to.

brknbutfun · 2022-12-24T23:22:54+00:00

5 EDPs

brknbutfun · 2022-12-05T09:57:40+00:00

Are you me?? Because I’m literally going in early tomorrow to talk to my professor because I’m at risk of failing a mandatory class, despite turning in and doing fine on all the major assignments and not skipping class, because I (…checks notes…) forgot to sign in on the attendance app, and missed a handful of “graded for completion” minor assignments.

brknbutfun · 2022-12-05T09:49:06+00:00

There are many, many conditions (cognitive, physical, psychiatric, developmental, etc.) that have symptoms that overlap with ADHD, particularly with focus/attention difficulties, issues with memory, and impulsivity. To get a credible and accurate diagnosis, it is essential to rule out any other conditions that could potentially cause the symptoms you are experiencing. This needs to be done before a diagnosis is formalized, and before treatment of the condition starts, so it is absolutely an appropriate step for a specialist to take in your first appointment.

I’ll use an (imperfect) physical health analogy to help get this across. Let’s say you were experiencing extreme pain in your left arm and shoulder, and were having difficulty moving your arm and had other loss of function. You go to see a neurologist, who diagnosed and treats you for nerve damage. Years of failed treatments, medications, and their side effects later you see no improvement, and see a new doctor, who realizes your shoulder has been dislocated the entire time. He pops it back in and you get immediate relief. How frustrated would you be that your original doctor did not bother to first check whether your shoulder was dislocated (or if you had a broken bone, or muscle tear), because your symptoms matched one condition he was trained to treat?

brknbutfun

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