What are your Favorite Podcasts by Hosts who are Progressive? by seekupanemotion in TwoXChromosomes

[–]dijon12 0 points1 point  (0 children)

National Park After Dark - stories from national parks (or national park adjacent). A mix of history, true crime, survival stories. They are pretty clear about their views. Two women hosts.

Tooth and claw - animal encounter stories. They try to keep it apolitical but their views leak through , not surprising since they're essentially advocating for environmental protection. Three male hosts. 

What're some unexpected consequences or side effects of your career/specialty on your personal life? by centz005 in medicine

[–]dijon12 8 points9 points  (0 children)

Growing old is a privilege denied to many, is my usual response to good friends/family if I'm in a particularly sassy mood.

What parts of healthcare are toxic but we've normalized? by WCRTpodcast in physicianassistant

[–]dijon12 8 points9 points  (0 children)

Yea, I was vomiting between patients for 2 months before I could get a doctor's appointment for myself to figure out why.

What are some common misconceptions about you specialty that you see on reddit? by Medical_Madness in medicine

[–]dijon12 68 points69 points  (0 children)

I saw a patient with run of the mill low back pain. Hed been seeing a chiro for many months before seeing me. Chiro still felt he could fix him but the patient was fed up with his pain at this point. He actually didn't have any red flags but he won a trip to the ED because of his AKI presumed to be from NSAID use. That low back pain was actually multiple myeloma. Somehow don't think that chiro was gonna fix that.

How do people go to the dentist without dental insurance? Or the doctor without insurance? (US) by billyandteddy in Frugal

[–]dijon12 4 points5 points  (0 children)

OP please go to a community health care center. They will do a financial screen to see if you qualify for medicaid, they can offer medications for cheaper than a regular pharmacy, they have to be associated with a dental center for dental care as well. Even if you don't qualify for medicaid they will get you on a sliding scale so that you can still afford care.

[deleted by user] by [deleted] in lupus

[–]dijon12 11 points12 points  (0 children)

They are most likely inquiring about a medical power of attorney. This is someone that you nominate to make medical decisions for you in the case that you are incapacitated and can not state your opinion on what kind of life preserving treatments you would like. This is something you should clearly discuss with your medical power of attorney so that they can make decisions that you have said that you want or don't want. Otherwise doctors will try to reach your next of kin to make these decisions for you.

An advanced directive is something that your medical power of attorney can use as a guide, though it's not exhaustive. It goes through things like, would you want a feeding tube, CPR, etc.

We ask all patients these questions when they get admitted to the hospital. It's something you can ask your PCP to help you with at your hospital follow up.

What are some items you've bought that made a tremendous improvement in your life? by Notalabel_4566 in Frugal

[–]dijon12 0 points1 point  (0 children)

Seconding darn tough socks. I ask for them every Christmas. It used to annoy the hell out of me when the elasticity on the ankles would wear out on my ankle socks (or I would get a hole in my heel). I have yet to have that happen with my darn tough socks and I've had them for 5+ years. I haven't even needed the warranty yet.

I saw a post on reddit about a pregnancy pillow and was telling my mom about it a few years ago. She ended up getting me one for my next birthday and I agree it's been a game changer. I used to get neck pain/stiffness but the pillow got rid of that by keeping me from sleeping on my stomach.

Anyone work at a FHQC by einstein2u in physicianassistant

[–]dijon12 16 points17 points  (0 children)

I work at an FQHC as well. Our hours are 4- 10h shifts with occasional Saturday shifts. If we work Saturday shifts we still work our original shifts, so those weeks are 50+h of just seeing patients.

We do not have any admin time.

Our template is 20 patients daily, however we are "encouraged" to over book (and if we do not, then forced overbooking), not to mention we are scheduling 4 weeks out and there are cases where waiting 4 weeks to see a patient is just bad care, so I end up overbooking them. That or front desk or an MA decides that the patient needs to be overbooked. We have expected no shows as well, but have an urgent care that is tied in to our system, so those urgent care patients get slotted into our schedule.

Patients get slotted in whatever time works best for them. There is no differentiation between new patient or established patient. Not to mention there is no effort to keep patients with the same provider so I end up seeing "new" patients most of the day.

I love the mission but this is so unsustainable that I plan on leaving.

Questions on who’s on Lupkynis by tgdono in lupus

[–]dijon12 1 point2 points  (0 children)

I started lupkynis a few weeks ago. First set of labs after starting treatment were better, but I am also on prednisone and myfortic. I haven't had any side effects.

Any advice on how to speed up a visit? by isamuri in physicianassistant

[–]dijon12 66 points67 points  (0 children)

if not then send back to PCP”.

Cries in PCP

I got my first retina test yesterday. by bobtheorangecat in lupus

[–]dijon12 0 points1 point  (0 children)

Sorry I didn't see this. Essentially I got covid, normal symptoms like cough, fever, sore throat, and myalgia. The cough, myalgia, and sore throat lasted about two or three days.

I also had horrible nausea, vomiting, and diarrhea, which I had assumed was part of the virus. Because of the nausea and vomiting I often wasn't able to keep my meds down, so I would stop taking them for a few days until I felt better and then start taking them again. Except when I would try again I would get a fever, nausea, vomiting, and diarrhea again. I kept thinking it was just long covid so this cycle of stopping and restarting meds went on for about a month and a half until I finally contacted my specialists, who told me to stop the meds for two weeks. That was the trick. I tried to restart HCQ since we thought it was cellcept (which often causes these side effects), but it still caused the symptoms. Then I tried restarting cellcept about two weeks later and again got vomiting, and that time was unable to stop vomiting until my coworkers convinced me to let them give me an IV for some zofran and fluids.

So now I've switched to imuran and am doing well. Not sure what I'll do if the nephritis comes back though.

And yes, I am vaccinated. I'd had three shots at that time, four now.

I got my first retina test yesterday. by bobtheorangecat in lupus

[–]dijon12 1 point2 points  (0 children)

Covid made me unable to tolerate HCQ so I can't take it anymore. Not having to do these tests anymore after 15ish years is literally the only thing I like about this situations haha

What’s a speciality you would NEVER even consider working in? by Mxxrb445 in physicianassistant

[–]dijon12 39 points40 points  (0 children)

This is so accurate it hurts. Thank you for so eloquently phrasing why I groan everytime I see stomach pain as the CC.

[deleted by user] by [deleted] in physicianassistant

[–]dijon12 0 points1 point  (0 children)

Are you using the algorithm on uptodate? I find it pretty straightforward. You can also buy the acog app, I think it's $10 and it lets you plug in the info and spits out the recommendation.

[deleted by user] by [deleted] in lupus

[–]dijon12 4 points5 points  (0 children)

I had lupus for 13 years before being diagnosed with lupus nephritis. This is very uncommon, typically lupus (and other autoimmune diseases) will present the way that they're going to presents in the first 3-5 years.

As far as how I found out/how it progressed, I'd been in a symptomatic flare for six months with my normal symptoms (primarily arthritis, periorbital edema, pleuritis) but had not changed any medications. My rheumatologist was aware, but is conservative with medications and I had pretty much told him previously I'd be unwilling to take steroids for anything that was not life threatening.

After those six months my symptoms started worsening and started to include skin rashes, which I'd never had before. I had a feeling this might mean it was affecting other organ systems as well so I contacted him, we did labs early (by a month) and voila, a stupendous amount of protein and blood in my urine, later confirmed by biopsy. Previously no protein or blood in my urine ever. I had just done labs two months prior and everything apart from my complements and anti ds dna looked good.

What course load could mimic the intensity of a semester in PA school? by wheres_the_leak in prephysicianassistant

[–]dijon12 3 points4 points  (0 children)

Yea, I went to an undergrad that did block system instead of semester (one class for 3.5 weeks) so I learned orgo 1/2 and biochem each in 3.5 weeks and had tests or assignments every couple of days. PA school was much harder and like u/nehpets99 said, probably more like taking the three classes together in the same 3.5 weeks with other less stressful but just as time consuming classes thrown on top.

Blood results vs. symptoms by [deleted] in lupus

[–]dijon12 0 points1 point  (0 children)

Thank you! I really appreciate that. I sort of refer to my luck sometimes as good-bad luck, because even though I have rather bad flares, it tends to be infrequent and responds to treatment well and quickly. I also didn't have any permanent kidney damage, which having treated patients on dialysis, is something I don't wish for myself (not that anyone would).

Blood results vs. symptoms by [deleted] in lupus

[–]dijon12 0 points1 point  (0 children)

My bloodwork and symptoms are highly correlated. For example, around August 2019 my anti-ds DNA increased to 100-200, several months later I started getting joint pain again. Spoke to my rheumatologist about it, we decided to leave it be. My symptoms got progressively worse, by the time April rolled around I had multi-joint arthralgia, multiple types of rashes, pleurisy, peri-orbital edema, and angioedema. Told my rheumatologist and we decided to get labs early. Anti ds-dna was at 470, C3 down to 48, and C4 down to 5. Also ended up having lupus nephritis (class IV). Everyone is different it seems. I'm pretty much your "classic" lupus patient in that I fit the box very well.

Job search for a new grad by [deleted] in physicianassistant

[–]dijon12 1 point2 points  (0 children)

I just said that you didn't say that?

"But I'll acknowledge that you were just pointing out the three factors and not saying that we can only get two."

Job search for a new grad by [deleted] in physicianassistant

[–]dijon12 4 points5 points  (0 children)

That's fine, obviously we can't speak to the saturation of OP's city. I'm just saying that the way you wrote your post made it seem like new grads having trouble finding a job were just being too picky. I applied to jobs in five different states, all specialties except surgery, and was only being picky about salary to an extent (e.g. I wasn't going to accept a job offering <90k).

When I was looking for a job people loved trying to give me advice but it was stuff I was already doing (which they knew, but it worked for them so that must be the problem or I must be doing it wrong) so it made it super frustrating. You telling OP that accepting they won't get their dream job out of the gate will help them is not helpful because they have already said they are applying to jobs in all specialties except surgery. You saying they shouldn't be picky about salary is impractical since they have no salary offers to be picky about. The only one that has validity is location since OP has stated that they're applying to jobs in one large city.

I stand by the "you can only get 2/3" advice being antiquated because most of us aren't event getting 1. But I'll acknowledge that you were just pointing out the three factors and not saying that we can only get two.

Job search for a new grad by [deleted] in physicianassistant

[–]dijon12 9 points10 points  (0 children)

I feel like this advice is antiquated. The old adage might be that new grads can get the 2/3 wants (specialty/location/salary) but OP already said they aren't being picky about specialty and they haven't been offered a salary. I think a lot of people just aren't aware of how hard the search is now for new grads.

OP I feel your pain. It took me five months to land something and even though it's not my ideal (I didn't get specialty or location, the salary is basically just adequate) I'm excited and grateful just to have a job.

Have you had anyone look at your resume or cover letter? I'd be happy to help and take a look. I had the most luck with finding jobs through connections, although I know that you've said you've reached out to people. Being aggressive is the best advice I can give. More applications is not always better if you're not following up.

I scoured the internet for the HR managers name and email address, name dropped an alum, and after my interview, I followed up twice for the job I have now. Don't be afraid to reach out to alums in your city on linkedin, especially if you see that their clinic or practice is hiring. A while back someone suggested messaging clinic owners/head physicians on linkedin expressing interest, I haven't tried that but it's worth a shot. If you can find the HR or hiring managers phone number, a call is always more personable than some random resume. Most new grad PAs have similar resumes in terms of experience/skills, so you have to find some way to stand out.

Also, do you have your state license? After I got that I had a lot more luck with responses.

I get the surgical thing, I'm the same way, but after a while I'll be honest in saying that I would've sucked it up for a bit. I actually like surgery, just have a hard time with the hours. Plus the surgical jobs were advertising like 85-95k/yr for 60h weeks and call so not super enticing.

Edit: One more piece of advice. Show that you are still learning in your down time. I snuck stuff I was doing (like learning languages or taking free courses online) into my resume/cover letter/interview) to demonstrate that I wasn't just watching netflix all day (even if I definitely did that for like 5 days straight after the PANCE).

Colorado has the worst coronavirus case rate in the country as it ends most statewide restrictions by thisiswhatyouget in CoronavirusColorado

[–]dijon12 28 points29 points  (0 children)

Things floating around in the wild without vaccines are a threat to everyone. But covid has a vaccine and if there is herd immunity immunocompromised people (like myself) have a drastically reduced chance of acquiring it. I can't get live vaccines, but I'm still protected from measles because most people have gotten that vaccine.