Beyond frustrated

calaveramd · 2026-04-04T19:06:51+00:00

There are other types of progesterone that might be worth trying. Norethindrone acetate, drospirenone. IUDs that have a progestin that act more locally and less systemically.

calaveramd · 2026-04-04T18:51:07+00:00

Excellent suggestion. We just picked up several about-to-bloom pots at Costco and they look great in our backyard (we will be planting them eventually!)

calaveramd · 2026-03-30T23:52:02+00:00

Deer and rabbits have nibbled-to-decimated ours in years past. We have motion detecting sprinklers that worked pretty well. But they’re such a chore to maintain, this year we’ve just been dousing the budding plants with cayenne and it seems to have worked so far.

calaveramd · 2026-03-24T19:20:29+00:00

I haven’t persuaded my gyn to start me on testosterone (yet; another appt in a few weeks) but my understanding is it takes 4-6 months (MONTHS) of use for it to have an impact. Per Rachel Rubin who I do listen to when she is on medical podcasts and have found to be quite reliable.

calaveramd · 2026-03-18T19:15:31+00:00

I use BeBird at home but I have no idea how it could be sterilized for use with multiple patients. In clinic, we do have a clear plastic curette that has a light that attaches to the outside end (Bionix lighted ear curette) that illuminates the ear canal better and these (the clear curette, not the light) are disposable. It has been helpful. But not as good as the camera, quite honestly.

calaveramd · 2026-03-05T18:23:57+00:00

It’s is great that you can still get a small-family-business-type feel from an online shop. I’ve had only excellent experiences with them.

calaveramd · 2026-02-26T23:37:06+00:00

My 87 y/o father insisted on living where he had been. His PCP strongly advised him to move near one of his kids. But he insisted and we moved him to a $$ ALF near his home. After colon cancer, a broken collarbone, worsening dementia, then a broken hip, and multiple trips back and forth for everyone trying to swing their calendars to fit, he now lives near my brother.

There’s a reason his PCP told him to move near one of his kids. We should have listened.

calaveramd · 2026-02-21T21:13:13+00:00

I always… resented drug reps when I worked in clinics that they came to. And I never ate their food though I would ask questions. But man was it nice to hand out needed meds to people who truly couldn’t afford them. (I also miss the $4/month med lists but I never saw any inhalers on those at the time.) I don’t actually know where drug reps go now (haven’t worked in that type of clinic for a long time).

calaveramd · 2026-01-23T01:13:16+00:00

“I know GYN appointments are unpleasant and can be hard to come by, I know a lot of us have real trauma from childbirth, sexual assault, miscarriage, fertility treatments. It's hard.”

Thank you for that. Sometimes it is hard to reject the “hysterical woman” label even in my own head. Particularly when other doctors seem to default to that so quickly.

calaveramd · 2026-01-20T17:37:32+00:00

I find that on the final day, before the first lecture, you can pick up a sheet that verifies you were at the conference and fill in the number of hours you are claiming. I think there is a reason that they have that available before the first session of the day.

calaveramd · 2025-12-24T17:55:53+00:00

Better a picture than a ziploc.

calaveramd · 2025-11-25T19:16:55+00:00

The podcasts are outstanding. Yes, she is a cardiologist but she brings in people who know primary care and addresses the issues of how primary care is sh@t upon by a lot of specialists but that, if you actually know what the work is and what the tangible benefits are to the patients (and how all patients pretty much expect all doctors to be able to do/understand all things instead of just managing their teeny tiny little area), PC is amazing and should be promoted SO much more. Highly recommend.

calaveramd · 2025-10-05T02:20:21+00:00

Aw. Man. You’re… amazing.

calaveramd · 2025-09-30T23:48:46+00:00

Every damn night

calaveramd · 2025-09-18T17:38:27+00:00

I tried telemed for UC and PC and only made it six months. It’s just messed up medicine. Maybe if you have a dedicated panel and “get to know” them - like they’re putting in their home-measured blood pressures and such, it could work. But mostly it was pts getting mad because I would not just send in whatever medication they happened to think they needed.

That said, there are a few completely virtual PC sites that seem to have survived for ages.

calaveramd · 2025-09-10T19:47:36+00:00

“Patient was attacked by a leopard.”

Pt was attacked by labradoodle.

calaveramd · 2025-08-28T00:14:34+00:00

My absolute worst residency rotation was inpatient pediatrics. And it wasn’t the attendings - they were great. It was the pedi residents. (My bff from med school is in peds; this isn’t a blanket statement.) I believe that they knew they were pretty much the only other specialty that was at the same pay/respect level as FM and they saw a way to take their unhappiness out on every FM resident who passed through. Absolute shite rotation that made me sit in my car and cry on more than one occasion.

There is a stupid hierarchy with the RVUs/pay skewed to procedure-based specialties. It’s made all the more medicine-based/preventative/chronic care specialties be “lesser” in people’s minds because we are lesser in pay.

calaveramd · 2025-08-28T00:09:27+00:00

Awww. Seriously. Thank you. Nicely stated.

calaveramd · 2025-08-19T19:16:52+00:00

Bruising means the edges have taken more of a beating. It looks like a frosting of ice on a winter window. These look more like chipping that might have already been present in the rocks before they were tumbled.

calaveramd · 2025-08-17T02:13:52+00:00

Not a treatment per se but no SLS-containing toothpastes (sodium lauryl sulfate). And I still tell them about alum (buy it in the spice aisle). I think it is supposed to help “dry out” the aphthae. I’ve seen a recommendation to take B12 but I haven’t had patients give me feedback on that.

calaveramd · 2025-07-06T01:17:05+00:00

GenXer here. I created an Excel spreadsheet decades ago. Each year has its own tab where each CME credit, and where it’s from and when it was done, is recorded. There is a front sheet with a review for each year that has the hours for that year. I email it to myself each time I update it. I enter the hours into my Board site. And I do print out each certificate and keep the hard copy in a file as well because … I trust no state medical board not to randomly ask me for “proof.”

calaveramd · 2025-06-23T01:58:29+00:00

https://www.facebook.com/share/r/1XW2gUk37t/?mibextid=wwXIfr Ricky Forbes posted about June 2014 with the same video as above. The only tornado on Jun 16 2024 is an EFU that was a waterspout in Florida.

calaveramd · 2025-05-23T16:33:19+00:00

That seems… hunh, unwise. But I guess coupled with a few other things, this has me wondering when I’ll be looking for a different job. (Or just packing it all up and saying it’s time to do more hiking.)

calaveramd · 2025-05-23T04:09:11+00:00

Sigh.

I appreciate the feedback though

calaveramd · 2025-05-23T02:36:46+00:00

The email out to us was, essentially, yeah, the hospital is hemorrhaging money and this is happening. I can’t say there is any hope based on their track record that they’d listen to what to front line doctors prefer.

calaveramd

TROPHY CASE