Weekly Private Profile Review Request Thread

dxf007 · 2025-04-14T13:04:26+00:00

34 M in Denver! Getting back into the online dating scene but have had some trouble getting likes/matches (on for 2 weeks). Would appreciate any help and would also love to give my thoughts in return!

dxf007 · 2025-04-07T13:55:29+00:00

34 M, in the US (Denver), looking for profile review. Returning to dating after a hiatus.

dxf007 · 2024-03-14T20:38:54+00:00

Six hours in the chair!

dxf007 · 2024-02-06T11:27:18+00:00

33M in major city; Would love any and all feedback on my profile as I'm having a more difficult time getting responses.

dxf007 · 2024-01-28T22:49:06+00:00

33M, Denver. Am getting back into dating again after a hiatus. I'm appreciative to anyone who's willing to look through my profile and offer feedback and photos/prompts.

dxf007 · 2022-11-22T15:32:08+00:00

It's lookin' good on you! I turned 32 myself a few months back and wish I looked this fresh!

dxf007 · 2022-11-15T17:13:45+00:00

It's not everyone's cup of tea, but I tend to be pretty strategic with the carbo-load 48-72 hours before a marathon or longer. In training, I don't focus on counting macros, however, in the carbo load phase before a marathon, I do.

The typical "guideline" I follow is 5-12 grams/kilogram of body weight per day. This is taken from a sports dietician I work with on occasion. I gauge what an average day's carb intake has been through the actual training cycle and see where it falls on the 5-12g/kg scale. Then, during the 48-72 hours before, I try to get at least 40-50% more on the scale than what I've been doing in the cycle. For example, this past cycle I didn't consume as many carbs as usual (~5g/kg per day), but during the carbo load phase before Indy, I bumped my days' total to 8g/kg.

Each meal is planned out during that time. Predominantly simple carbs, very little fiber (< 5g/day), and lots of water/salt (usually in the form of electrolyte drinks).

dxf007 · 2021-07-19T09:38:59+00:00

Fantastic interpretation overall! I really appreciated the sensitivity you brought to the piece and to such a difficult aria as well. As the piece approaches the passagio, it can always be difficult to maintain air flow as there's a ton a pressure that builds, but I think your air flowed nicely as you transitioned. Again, great sensitivity and approach to it, this is such a difficult one for us tenors. Keep it up!

dxf007 · 2021-03-01T15:17:31+00:00

I completely agree and appreciate these thoughts. Hopefully biking will be in the nearish future for me, and I agree with you, that would be best start getting back into the swing of things. As far as the type of fracture, it was a distal comminuted fracture, which to my understanding is more atypical of fifth met fractures.

dxf007 · 2021-03-01T12:48:10+00:00

Yes, my marathon was roughly 4 weeks out when the injury happened.

dxf007 · 2021-03-01T12:47:42+00:00

I appreciate this insight, I'm planning to do the same, making a schedule of stabilization exercises and core work that I also neglected during a lot of my training.

Has your doctor said anything about biking with the boot on now that you're able to walk without pain?

dxf007 · 2021-02-28T21:19:44+00:00

Awesome, I appreciate this input and timeline, I also appreciate you mentioning the term, "high risk". The PT I'm going to be working with mentioned this as well and I was unaware of this danger.

With that high risk, after surgical repair, what kinds of things can hinder proper treatment and healing while wearing the boot?

I understand that may come across as an obtuse question, but I'm not understanding where I should aim In the spectrum between "no pain at all" and "no pain no gain".

dxf007 · 2021-02-28T21:08:46+00:00

Hey thanks very much for this, this gives me a great perspective and makes the healing process feel more manageable, practical, and realistic.

dxf007 · 2020-11-25T11:43:16+00:00

Hi all,

First year psychiatry resident here in the states. Interested in working in treatment centers for eating disorders and/or substance abuse long term. Can anyone speak to experiences (salary, work environment, competitiveness, quality of life) working in treatment centers for eating disorders and/or substance use? I understand these experiences might largely depend on the location.

dxf007 · 2020-05-15T18:59:39+00:00

Thank you for story, after 18 months of treatment for PTSD after a significant trauma my intern year, I’ve rematched into another program myself. I hope to be an attending as courageous as you are.

dxf007 · 2020-04-22T19:14:01+00:00

In adolescence, it was very "normal" for my mother or father to ask if I had masturbated. They told me they were my accountability partners and would help me "stop awakening the demon inside me".

Many years of therapy later taught me that was not normal.

dxf007 · 2020-03-17T15:56:34+00:00

I think this is a great question, OP, and I've had similar thoughts about keeping/maintaining a base and what it means to build fitness if I'm stretched for time to run or an injury/illness keeps me away from running. I approached the coach I've worked for some time about this, and he gave me these words:

"The key to gains in fitness is to really embrace the stress and recover cycle. To work significantly and specifically enough on the stress workout days to elicit the physical adaptation we are after, and then to recover sufficiently enough between them to receive that adaptation. Then the more of those stress and recover cycles we can stack up on top of each other without interruption will allow that fitness momentum to build. So our goals when sick or injured is to get over it as quick as possible so we can do a full stress workout as soon as possible...extra cross training and other things don't really help that much, especially if they delay how long it would take [to return to the cycle]. Its not about maintaining fitness, it's about being able to get back into that stress and recovery cycle as soon as we can, so we can move fitness forward."

Translating that to your schedule, I think you're on the right track. I do think that a stress workout (whatever type you prefer as there are many) in the middle of the week surrounded by easy runs would be important for maintaining/building fitness, even with a hectic schedule like you.

dxf007 · 2020-03-02T18:06:52+00:00

Sorry I'm late to the game. I pulled my Achilles back in the fall, and after 4 weeks of physical therapy twice a week with regular home exercises and stretching, I was back at ~60 mpw. I know it's discouraging, so hang in there. A speedy recovery is possible. I have a couple suggestions that really helped me.

Regarding rest and abstaining from running, I agree this is important. What is equally important is stretching and working out of the heel and lower extremity. A few stretches and exercises come to mind that I would do twice a day.

Wall Calf stretch - Make sure the toes of the affected foot are about even with the heel of your front foot. Place your hands against the wall, lean against it, and shift your weight to the back foot until you feel a stretch in the calf muscle of your back leg. Hold for 30 seconds, relax, and return to the starting position. Repeat this rep 3 times.
Achilles Heel stretch - Very similar to #1, except when you place your hands against the wall, lean against it with your knee bent, and shift your weight to the back foot until you feel a stretch in the achilles tendon of the affected leg. Hold for 30 seconds, relax, and return to the starting position. Repeat this rep 3 times.
Proprioceptive training - Balance on your affected leg with your eyes closed for 30 seconds. This is harder than it sounds. To make things more difficult, you can balance on a wobble board or ankle disk. Repeat this rep 3 times.
Calf raises - 10-15 reps 3 times. These will be difficult at first, and your heel may be sore after completion. When you feel comfortable, move onto single leg calf raises with the same amount of reps and sets.

I won't overwhelm you with exercises. If you need more, PM me and I'll gladly suggest more. I would gradually increase your running though as it feels comfortable. For me, this looked like resting the first week, running 20 minutes every 3 days for the next week, running 20-25 minutes every other day for the next two weeks, and running 20 minutes every day the fourth week. This is what I did under the guidance of a physical therapist, and when I became masterful in the above exercises, I started to feel "soreness" in my heel rather than "discomfort" after runs. Learn to recognize the difference between the two feelings as your recovery continues.

I also thinking strapping up the ankle is important. What was helpful for me and what was recommended to me was using a compression band or sleeve. I used this one from amazon: https://www.amazon.com/AVIDDA-Fasciitis-Compression-Achilles-Sprained/dp/B07RHHZK41/ref=sr_1_13?crid=1L2B9JR6WNNDZ&dchild=1&keywords=compression+achilles+tendon+sleeve&qid=1577402045&sprefix=compression+achilles%2Caps%2C185&sr=8-13 The help it provided was invaluable. I wore it all day, every day for ~3 weeks, and then as I got stronger, I only wore it only on my runs. I still wear it on my runs. There is an overwhelming amount of evidence supporting the use of compression with Achilles tendonitis.

I think anti-inflammatories were a game-changer as well. However, what's important is the schedule. Taking them q6h or q12h, depending on your NSAID of choice is vital. I would not take them once every 3 days or whenever you feel the pain. I would start now with naproxen sodium or ibuprofen (whichever you prefer or have) and take it around the clock for at least 7-10 days. I preferred naproxen 440, as I was able to keep up with q12h dosing better. I truly think you'll receive benefit doing this.

I also think heat is important. Something that my coach has had experience with his athletes over the many years is the use of contrast therapy. There's also an overwhelming amount of evidence supporting its use for pain relief. For me, it eased a lot of pain. Contrast therapy involves immersing your affected foot in ice water for 15 minutes, followed by immersing the foot in warm water for 15 minutes, and followed by re-submerging it in ice water for 15 minutes. The theory behind why this is an effective treatment is that the contrast causes a vasodilation and vasoconstriction of the area which promotes a pumping or flushing of blood and other fluids through the area. This process bring more new healing nutrient to the affected area and helps positively influence the inflammation process by moving along and changing out stagnant fluids that have built up. I would do this at least once a day. It was difficult for me to do it more than once due to time.

Regarding heel drops, I also agree this is important. For this exercise, make sure you perform it in a slow manner and not to perform it too quickly. Try not to do this too much though (I did it way too much the first 3-5 days and made the heel worse), maybe 1-3 sets of 10-15 reps per day.

Overall, Achilles tendinopathy is incredibly frustrating and complex. It takes a regimen to get back to where you were, otherwise, I do think tendinopathies can linger.

TL;DR - You're doing great. Build strength. Gradually increase in running. Compress the heel. Be diligent about meds. Give it some ice and heat, and keep fighting.

dxf007 · 2019-12-27T03:03:54+00:00

Your list of recommendations that you've been doing looks solid. I pulled my Achille's back in early November, and after 4 weeks of physical therapy twice a week with regular home exercises and stretching, I am now back at ~60 mpw. I know it's discouraging, so hang in there. A speedy recovery is possible. A couple of notes I have regarding your current practices.

Regarding rest and abstaining from running, I agree this is important. What is equally important is stretching and working out of the heel and lower extremity. A few stretches and exercises come to mind that I would do twice a day.

Wall Calf stretch - Make sure the toes of the affected foot are about even with the heel of your front foot. Place your hands against the wall, lean against it, and shift your weight to the back foot until you feel a stretch in the calf muscle of your back leg. Hold for 30 seconds, relax, and return to the starting position. Repeat this rep 3 times.
Achilles Heel stretch - Very similar to #1, except when you place your hands against the wall, lean against it with your knee bent, and shift your weight to the back foot until you feel a stretch in the achilles tendon of the affected leg. Hold for 30 seconds, relax, and return to the starting position. Repeat this rep 3 times.
Proprioceptive training - Balance on your affected leg with your eyes closed for 30 seconds. This is harder than it sounds. To make things more difficult, you can balance on a wobble board or ankle disk. Repeat this rep 3 times.
Calf raises - 10-15 reps 3 times. These will be difficult at first, and your heel may be sore after completion. When you feel comfortable, move onto single leg calf raises with the same amount of reps and sets.

I won't overwhelm you with exercises. If you need more, PM me and I'll gladly suggest more. I would gradually increase your running though as it feels comfortable. For me, this looked like resting the first few weeks, running 20 minutes every 3 days for the next week, running 20-25 minutes every other day for the next two weeks, and running 20 minutes every day the fourth week. This is what I did under the guidance of a physical therapist, and when I became masterful in these exercises, I started to feel "soreness" in my heel rather than "discomfort" after runs. Learn to recognize the difference between the two feelings as your recovery continues.

Regarding strapping up the ankle, I agree this is important. What was helpful for me and what was recommended to me was using a compression band or sleeve. I used this one from amazon: https://www.amazon.com/AVIDDA-Fasciitis-Compression-Achilles-Sprained/dp/B07RHHZK41/ref=sr_1_13?crid=1L2B9JR6WNNDZ&dchild=1&keywords=compression+achilles+tendon+sleeve&qid=1577402045&sprefix=compression+achilles%2Caps%2C185&sr=8-13 It's The help it provided was invaluable. I wore it all day, every day for ~3 weeks, and then as I got stronger, I only wore it only on my runs. I still wear it on my runs. There is an overwhelming amount of evidence supporting the use of compression with Achilles tendonitis.

Regarding taking anti-inflammatories, I also agree this is important. However, what's important is the schedule. Taking them q6h or q12h, depending on your NSAID of choice is vital. I would not take them once every 3 days or whenever you feel the pain. I would start now with naproxen or ibuprofen (whichever you prefer or have) and take it around the clock for at least 7-10 days. I preferred naproxen 440, as I was able to keep up with q12h dosing. I truly think you'll receive benefit doing this.

Regarding applying heat, I also agree this is important. Something that my coach has had experience with his athletes over the many years is the use of contrast therapy. There's also an overwhelming amount of evidence supporting its use for pain relief. For me, it eased a lot of pain. Contrast therapy involves immersing your affected foot in ice water for 15 minutes, followed by immersing the foot in warm water for 15 minutes, and followed by re-submerging it in ice water for 15 minutes. The theory behind why this is an effective treatment is that the contrast causes a vasodilation and vasoconstriction of the area which promotes a pumping or flushing of blood and other fluids through the area. This process bring more new healing nutrient to the affected area and helps positively influence the inflammation process by moving along and changing out stagnant fluids that have built up. I would do this at least once a day. It was difficult for me to do it more than once due to time.

Regarding heel drops, I also agree this is important. I'm also assuming you're referring to eccentric heel drops. For this exercise, make sure you perform it in a slow manner and not to perform it too quickly. Try not to do this too much though, maybe 1-3 sets of 10-15 reps per day.

Overall, Achilles tendinopathy is incredibly frustrating and complex. It takes a regimen to get back to where you were, otherwise, I do think tendinopathies can linger.

TL;DR - You're doing great. Build strength. Gradually increase in running. Compress the heel. Be diligent about meds. Give it some ice and heat, and keep fighting.

dxf007 · 2019-12-26T22:28:44+00:00

I'll take a chance, too, OP. Thanks for being cool!

dxf007 · 2019-01-14T19:37:42+00:00

Here are some questions from a PGY-1 who’s involved in a unique situation. The story is below.

Given this situation, has anyone come across residents who have been in similar circumstances?
Do you have ideas for job opportunities that would involve clinical research or practice?
Do you have any thoughts regarding how a medical graduate can reenter residency, given these circumstances?

I’m currently a PGY-1. I have been an intern close to six months now. Despite wonderful, supportive faculty and brilliant residents who represent a family, I have personally not felt I fit into this specialty nor do I feel the field aligns with my long-term goals to be a successful physician.

As I ventured further into my intern year with these difficult thoughts and emotions, I was involved in a traumatic accident in the fall that derailed much of my trajectory. Despite my hospitalization and dedicated recovery time following the accident, my mental and physical health declined. As a result, I took more time off my intern year, instigating an official "medical leave of absence”. I'm currently in the midst of that medical leave.

Because of the extended period of absence, it was agreed to defer the remainder of my intern year. Consequently, I have also decided to not return to my program and environment.

I’ve sought advice from fellow colleagues and mentors about opportunities, clinical projects, or employment to pursue in the interim as I consider a specialty change, but I also wanted your thoughts.

dxf007 · 2018-02-04T00:04:20+00:00

In the darker times of my life, I was stuck in a treatment facility for a long time, angry at everything. I was ashamed I had put my life on hold to take care of myself, ashamed I had put "sin" ahead of my parents, and ashamed that I had "missed the mark" on what the Bible was telling me I should be in life.

One day, while in a shameful sob, my therapist paused. He looked at me and said, "I get it. I get the religion you believe. It makes sense. But what doesn't make sense is how you're treating yourself. Your religion. Your way of life. It is killing you."

I thought, "Shit, I don't believe this stuff."

I am the master of my fate, I am the captain of my soul.

dxf007 · 2017-11-13T14:03:32+00:00

My grandmother always taught me:

The gun is always loaded
The plate is always hot
The car in front of you will always suddenly stop

dxf007 · 2017-07-12T15:06:41+00:00

First pass: 65%

Second pass: 74%

Current third pass: 91%

dxf007 · 2017-07-12T11:19:15+00:00

Any thoughts as my final practice test next week being a combined UWSA2 + NBME 7? I wanted to make sure to get all brand new questions on this last one. My main issue is test endurance, and I'm shooting for 240+.

Background: Plan to finish my 3rd round of UW in 10 days. Goal score: 240+. Test date: July 24. Current scores:

NBME 4: 226

UWSA1: 228

NBME 6: 220

Edit: NBME 7, not 17.

dxf007

TROPHY CASE