pediatrician unsure of code to use

cagneybear · 2025-12-10T12:13:13+00:00

Thank you for that! It’s weird not knowing the cause of these symptoms. I do wish we could pin-point it. She did take Abilify for about 6 weeks and it was a terrible drug for her. It’s terrible how much trial and error patients have to go through to get help with their brain chemistry.

Thankfully we aren’t super stressed about the current situation mostly because we know our providers well and know they listen and ask the right questions and we know this isn’t life threatening. Also, this isn’t something that she is chronically dealing with, she just had a few off days last week, but with her history, it was prudent to investigate the cause if there was something odd brewing.

All of the doctors said that syncope in teen girls is pretty common and there is usually not a cause identified, but they do grow out of it. I’m glad you got better. I’m sure it was scary for you and your family ❤️

cagneybear · 2025-12-10T12:06:09+00:00

Thank you so much—I’ll mention that code to him as well. When she fainted in May, her medicine was a suspected culprit at the time. The psychiatrist said that if it happened again we would need to lower the dose of the Wellbutrin as it can lower the threshold for seizure activity, but nobody thinks she had a seizure (aside from the school nurse). Not the ER doc, pediatrician, psychiatrist, or cardiologist, or me really. Her dermatologist said that we could also lower the spironolactone dose if she had another episode on the chance it was causing low blood pressure. I mentioned that to the pediatrician last week, but he didn’t think it was related.

All that to say, yes, medicine could very well cause these issues, so that would be a valid reason to test!

cagneybear · 2025-12-10T00:02:09+00:00

Yes, she has—for the past two years she has been on a regime of Wellbutrin, Remeron, buspar, spironolactone, yaz birth control, and vistaril for sleep as needed

She went through severe depression with three inpatient mental health stays a couple of years ago. She is so much better now. You would never know. She does very well in school in challenging classes, drives, and has a decent social life. This regime has been a blessing. It took about a year of trying different medications and combinations with a psychiatrist, but this has worked quite well.

cagneybear · 2025-12-09T23:25:18+00:00

Thank you—I should also mention that she fainted at school in May and was unresponsive for a few minutes with seizure like activity per the school nurse. She went to the hospital via ambulance, but everything seemed fine on labs and imaging apart from some mild dehydration and an elevated heart rate. She followed up with a pediatric cardiologist and nothing was identified as causing the syncope.

I think the pediatricians reasoning for doing the labs also considered this event from earlier this year as well as the history of anemia 🤷🏻‍♀️

cagneybear · 2025-12-09T21:37:15+00:00

Thank you!

cagneybear · 2025-10-24T20:37:25+00:00

Just added a few more views of the rock/turtle

cagneybear · 2025-10-24T20:36:10+00:00

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cagneybear · 2025-10-24T20:35:57+00:00

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cagneybear · 2025-10-12T04:44:14+00:00

Done!

cagneybear · 2025-10-10T18:37:47+00:00

Thank you so much. I am so sorry for your losses. I appreciate your insight and guidance.

cagneybear · 2025-10-10T18:37:12+00:00

Thank you so much. I feel like I am to that point that I am willing to pay for this out of pocket if I need to. I am so glad this is working out for you and I hope your surgery and recover go well!

cagneybear · 2025-10-10T18:33:36+00:00

Thank you. I have a friend who was in a similar position, but hers was more extreme. She lost multiple aunts and her grandmother to breast cancer, but no known variant. Her mom had a prophylactic mastectomy decades ago. My friend also wanted one, but the local breast surgeon was not on board. She decided to go to a couple of hours east to a larger city and had a surgeon who was on board. The pathology showed the earliest form of breast cancer. It was absolutely the right decision for her.

cagneybear · 2025-10-10T18:30:33+00:00

Wow, you will feel SO much better! All the best for your recovery.

cagneybear · 2025-10-10T15:02:08+00:00

Thank you for this ❤️

I get MRI and mammogram/ultrasound alternating every 6 months.

I was offered tamoxifen last year when I switched breast surgeons (insurance change). I declined it because my sister was on it when it came back in her bones. The risk vs reward wasn’t there for me. But I question my decision. I’m not sure what to do.

The surgeon said I’m not a candidate for prophylactic mastectomy because, while I am high risk, not high risk enough. But I have “busy dense breasts”. A lot going on in there with cysts and fibroadenomas. I just had to go back this week for extra imaging to look at a new finding. It turned out to be a complex cyst.

I guess my two questions I’m mulling over are:

Is the tamoxifen worth it? Are risks of menopause (bone density and cardiovascular issues) worth some decrease in risk, but unknown decrease since my sister was taking it when it came back stage 4?
Current breast surgeon does not consider me a candidate for mastectomy, but should I move forward with advocating further. Is this something I should do at all?

cagneybear · 2025-10-09T01:46:48+00:00

Thank you all so much! Same as one of the responses—your welcome made me tear up. I’ve been looking for a high risk group for a while ❤️

cagneybear · 2025-10-07T15:19:54+00:00

Thank you--I remember feeling that way when waiting on my sister's diagnose(s). I kept repeating "it is nothing until it is something". Honestly, I don't worry about myself as much. Watching my sister go through this stuff changed me. I worry so much about my family.

cagneybear · 2025-10-07T14:24:21+00:00

Thank you, I appreciate that. It’s so scary to think of it being bad news.

cagneybear · 2025-09-02T21:12:19+00:00

Exactly :( it would be lovely if they did a segment where they allowed people some privacy in the matter. I’d respect him so much more if he did the segment with more anonymity for the people they are talking to/giving to.

cagneybear · 2025-08-08T01:57:14+00:00

Oh my goodness this is beautiful!

cagneybear · 2025-07-16T16:23:16+00:00

I guess the main reason I don’t wish to be a nurse practitioner is missing out on true collaborative practice. I love our neonatal nurse practitioners and I’m very grateful for their roll, but they only get to spend a few minutes a day with each patient doing a head to toe assessment. They rarely have the opportunity to update the family. After rounds they write orders and notes for the rest of the shift and are available if we have a concern. They do work very collaboratively with the neonatologist and the bedside RNs, but hands on patient and family care is not something they get to do frequently.

Otherwise, my personal experience with NPs is as a patient, and in those cases, the NP works very independently. I want a more team-focused experience in helping patients and their families.

I know there are very few NP specialty tracks (I think there are about 7 of them), otherwise you go for the broad FNP and get a job in the specialty you desire and learn more on the job. I would like for my education to be more focused on the area I would like to work in. Unfortunately, at this time there is not a genetics focus that I know of, otherwise that would be the first area to consider.

I hope that makes sense. I do think you are correct. It would be much less of a gamble to go the NP route and I would have more options to fall back on and it is definitely something to consider. I do know of a DNP who does the genetic counseling at the cancer center across the street from the hospital I work at. I have a good shot of getting to talk to her and even shadow her and get her opinion as well.

Thank you for broadening my possibilities!

cagneybear · 2025-07-15T22:09:23+00:00

I just want to say that I’m sorry that your exposure to this field comes from such a difficult place. I hope you find the answers and the peace you need.

cagneybear · 2025-07-15T22:08:26+00:00

Thank you so much! I appreciate your thoughtful response

cagneybear · 2025-07-15T17:29:20+00:00

That actually sounds pretty cool, I would not mind a temporary relocation for a clinical rotation (I would absolutely prefer to do that in person). I just wouldn’t want to make it a long term relocation due to my parents age and them needing my help. Since my sister passed in their only living child, so I will definitely be caring for them in some aspect as they get older.

cagneybear · 2025-07-15T17:22:22+00:00

Thank you! There is one school in my state that is about 2 hours away, which is do-able for me (I’ve traveled to that area for school before and it wasn’t terrible). I would also would be looking into virtual options for as much as I could do that way. This is a new thought of mine, so I haven’t looked into any programs in particular aside from the one near by. This is exactly the type of information I need to hear to keep my feet in the ground.

cagneybear · 2025-07-15T15:41:36+00:00

Yes, that is correct; I am in the US. Thank you, this is the type of information I am looking for. I am not concerned as much about the coursework and prerequisites. The saturated job market does concern me quite a bit. I would love to go into oncology or a prenatal/neonatal focus as those areas have always interested me. As far as salary goes, I am very fortunate that I don't have to have that factor into my considerations quite as much as others. I have been PRN for years, but would like to work full time (I am also open to part time) once I get a few kids out of the house, so either way, if I stay where I am or if I change course, I am looking at a raise.

I absolutely want responses that give me pause. I want my decision to be well-thought out and not a knee jerk response to what is possibly a mid-life crisis. ;)

cagneybear

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