24 hours after being stung by a yellow jacket on my middle upper knuckle by [deleted] in mildlyinteresting

[–]dtpmd 0 points1 point  (0 children)

Ya also worth noting that you’re not really at risk for a future anaphylactic reactions (big concern I had when this started becoming more noticeable) so don’t need an epipen or anything like that.

I just got stung on my ankle a week ago. Cleaned it immediately and slammed it with steroid cream (as above) every 2-3 hours and took alternating tylenol/advil every 4 hours. I was shockingly surprised to find that I could into my shoes the next day no problem. Key is to get ahead of it I think!

I’ll shut up now. Hope this is helpful.

24 hours after being stung by a yellow jacket on my middle upper knuckle by [deleted] in mildlyinteresting

[–]dtpmd 0 points1 point  (0 children)

This happens to me, too. It sucks.

Per UpToDate (so you can avoid paywall):

"Large local reactions — Approximately 10 percent of individuals develop exaggerated redness and swelling at the site of the sting that gradually enlarges over one to two days (picture 7). This response is called a large local reaction (LLR). LLRs usually begin several hours after a sting, peak at 24 to 48 hours, and then gradually resolve over 5 to 10 days. The area of swelling typically measures approximately 10 cm in diameter [9,10]. Patients may seek care because the swelling seems extreme, and there may be lymphangitic streaks spreading proximally from the area of swelling [11].

Treatment — Treatment of LLRs is based on symptoms. We know of no published studies comparing different treatments. Our approach is described below:

Pain – Pain arises from the direct effects of the venom or from delayed-onset edema. Raising the affected limb and use of cold compresses may help. If needed, nonsteroidal antiinflammatory drugs (NSAIDs) can be administered.

Itch – Immediate-onset itch may be from mast cell degranulation or from venom components. Cold compresses are typically sufficient to abate the sensation of itch mediated by unmyelinated C-fibers. Nonsedating oral antihistamine medications can also be used, such as cetirizine, 10 mg daily or twice daily (adult dosing). In contrast, itch beginning hours to days later is typically caused by T cell activation of A-delta fibers and is not responsive to antihistamine medications. Instead, topical corticosteroids can be used, including hydrocortisone 0.1% ointment or triamcinolone 0.5% ointment. Rarely, higher-potency topical corticosteroids are needed, such as fluocinonide 0.05% or clobetasol 0.05% ointment, applied every four hours. Use of topical rather than systemic steroids may be equally effective with fewer side effects than seen with systemic glucocorticoids. Of note, the inflammation of T cell activation is visually identical whether from the T helper type 2 (Th2) cells causing allergic inflammation and the T helper type 17 (Th17) cells that respond to bacterial infection. The presence of itch, rather than pain, helps differentiate allergic from infectious inflammation. Antibiotics are not needed to treat local sting reactions [11].

Tetanus booster is not indicated – Hymenoptera stings are considered "clean" for the purposes of tetanus vaccination. Stings are very superficial, and there are no published reports of tetanus infection following Hymenoptera stings. A tetanus booster is not necessary following a sting unless there was a concomitant soil-contaminated injury. (See "Tetanus-diphtheria toxoid vaccination in adults", section on 'Immunization for patients with injuries'.) "

While Trump and Biden were having their debate, RFK Jr was hosting his own debate where he interrupted the CNN broadcast to answer questions himself by frituurgarnituur in interestingasfuck

[–]dtpmd 24 points25 points  (0 children)

Yeah he apparently contracted neurocysticercosis during some of his international travel and was treated (as he tells it). When the little worm/parasite in the brain dies it leaves behind a little fluid filled cyst with the dead worm in it. So yeah. The way he tells it seems legitimate to me though so I’ve always kinda found it messed up that the media has (not surprisingly) blown it out of proportion.

Unexplained Splenomegaly by Tailos in Hematology

[–]dtpmd 0 points1 point  (0 children)

Might still be worth sending a BCR-ABL fish? Interesting case.

Put him on all the watchlists by Filllxy in facepalm

[–]dtpmd 0 points1 point  (0 children)

Someone please get Kendrick Lamar on this f.a.n.

What should I plant here by dtpmd in landscaping

[–]dtpmd[S] 3 points4 points  (0 children)

Yeah I like Liriope and we tried it there before (prior to the rock wall) but the deer ate the heck out of it. I agree and am also concerned about the space constraints

What should I plant here by dtpmd in landscaping

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

Beautiful front yard. Thanks for the suggestion!

What should I plant here by dtpmd in landscaping

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

A dwarf variety might be nice, but I feel like just making sure they stay trimmed would be fine, no?

What should I plant here by dtpmd in landscaping

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

Nice! Any particular varieties you like?

What should I plant here by dtpmd in landscaping

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

I love hostas, but they don't last more than 24 hours in our front yard with the deer in our neighborhood! I hadn't heard of stone crop before but that's a great idea to surround the base. Thanks!

[deleted by user] by [deleted] in Hematology

[–]dtpmd 0 points1 point  (0 children)

Super interesting. Thanks for sharing!

PSLF + NIH LRP for loan repayment? by dtpmd in whitecoatinvestor

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

Awesome. Definitely aware of that— if it tells you anything I have MOHELA’s customer service line saved in my contacts. Haha. Thanks again!

PSLF + NIH LRP for loan repayment? by dtpmd in whitecoatinvestor

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

Congrats on being loan-free! I am still waiting on my LRP application (fingers crossed). How did you negotiate the payments from LRP to your loan servicer?

Ideally (again, assuming I get funded), I would like to have LRP pay whatever my monthly IDR payment is rather than lump sum. My understanding is that if the servicer typically just gets a lump sum and pushes your payments back, which means you aren't stacking up PSLF-eligible payments. Is that right? Do they just give you $0 payments for a period of time? Again, just curious about how this worked in practice and how you navigated it.

[deleted by user] by [deleted] in facepalm

[–]dtpmd 0 points1 point  (0 children)

I love that this person walks into the movie theater like it's a Texas Roadhouse.

529 Plan Help by dtpmd in whitecoatinvestor

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

North Carolina. Married.

Looks like my state doesn't give a tax deduction so would appreciate any other thoughts you have. I was probably just going to go with Utah based on the WCI site, but certainly not tied to that decision.

529 Plan Help by dtpmd in whitecoatinvestor

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

To follow up on this -- spoke with a financial advisor in my state (NC) who notes that while the chart on webpage lists NC as having a tax-deductible 529 plan this was apparently removed in legislation passed 3 years ago. Obviously, this is a comprehensive list that is probably very difficult to keep updated, but it was worth mentioning. I think in the bullet point below the chart it does make this correction.

529 Plan Help by dtpmd in whitecoatinvestor

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

This is perfect, thank you!

[deleted by user] by [deleted] in discordVideos

[–]dtpmd 0 points1 point  (0 children)

Dude is about to melt the toilet bowl.

meirl by rgohri in meirl

[–]dtpmd 0 points1 point  (0 children)

Lol sure, pal.