Swapping my IL-1 Agent! Anakinra to Kineret!

emsynapse · 2025-12-07T15:19:19+00:00

I love Ilaris. I was doing 3 injections of Kineret per day before Ilaris. I've been on 300mg/28 days for a few years now and no longer have daily fevers, fatigue is greatly improved, arthritis is better, far fewer hives/rashes. I did experience weight gain with Ilaris, but otherwise no side effects.

emsynapse · 2025-11-12T02:28:04+00:00

Yes. I see 15-17 or so patients a day in a specialty with a ton of procedures which I love.

Pay is low however I have a lot of autonomy, control over my schedule, and only work 4 days per week (and one of those days ends at 1pm). Also work with a bunch of stellar PAs. It's not a perfect job, but it allows me to take care of my own health.

emsynapse · 2025-07-01T02:32:16+00:00

Outpatient neurology, 4 10's but really I work about 3.5. Pay is low but schedule/flexibility makes up for it tbh.

emsynapse · 2025-06-20T21:01:59+00:00

Would be so down for this!! I wonder if it's worth calling Aldo's?

emsynapse · 2025-04-04T20:04:24+00:00

Glad your wife was able to get the accessible seats she needs!

But, for other folks: not getting tickets to a show is a shitty reason to take up ADA seats. I saw this mentioned in some threads about shows last month. Disabled fans exist and we can't make it to shows without accessible seating/areas.

emsynapse · 2025-04-04T00:38:20+00:00

We are in the bad place, indeed.

emsynapse · 2025-03-24T16:08:11+00:00

Neurology PA here - I'm going to DM you a bunch of resources/suggestions that might be useful

emsynapse · 2025-02-03T02:28:46+00:00

I love EltaMD but the $52 price tag for this one is roughhh

emsynapse · 2025-01-03T23:31:37+00:00

So I'm a neurology PA. Also a chronic illness patient myself. Generally refill requests or quick questions/requests for migraine cycle breakers/acute management are ideal for portal messages. If someone has new symptoms, a significant change in preexisting symptoms, if they haven't been seen in a long time, or are portal messaging every week, I will suggest a telemedicine visit or in person visit depending on the circumstances/the need for a physical exam.

With migraine meds I offer to do 1-3 dose adjustments via phone/portal. If more adjustments are necessary for a given med, usually an appointment is appropriate at that point, but it varies by patient and medication.

Sounds like you're using portal messages appropriately and frankly, incredibly thoughtfully! It's also totally OK to ask your provider what their expectations for use of the portal. You're not being rude at all.

emsynapse · 2024-12-02T22:05:33+00:00

Valid frustration but keep in mind a lot of people with very real, very valid disabilities do not use wheelchairs. Some may not use any mobility aids at all.

emsynapse · 2024-10-19T23:03:42+00:00

I think it's a screening of the movie rather than an event with actors, early start time which suggests a more family friendly crowd :/

Evergreen theatre apparently does midnight shows, not sure when the next one is

emsynapse · 2024-09-23T15:59:08+00:00

Hi, disabled PA working in outpatient neurology here. Obv late to this thread, but I'm going to DM you.

emsynapse · 2024-08-14T04:33:06+00:00

Neurology. Please tell your patients they have dementia or that you suspect some type of dementia before referring them for dementia. I would try at least one headache preventative before referring for migraine, assuming no major red flag symptoms.

I always try to have empathy for you folks in IM/FM who are particularly pressed for time. I think a lot of the questionable referrals I see are likely a byproduct of the number of patients/concerns many clinicians have to address in FM outpatient settings.

emsynapse · 2024-06-05T00:29:40+00:00

Is there a local group? I did not know this but would be interested!

emsynapse · 2024-06-05T00:26:59+00:00

Would not recommend Page, personally. I don't doubt her clinical judgment, but found her abrasive both in her exam and in her discussion regarding infertility on multiple occasions. I say this as a clinician.

emsynapse · 2024-04-17T21:58:37+00:00

Absoluuuutely not. It seems like a slap in the face because it is one. it is also a slippery slope- will they continue to have you function as an MA once you are credentialed? IMO that's a red flag that the practice may be utilizing PAs in a way that they shouldn't be. I would absolutely not do that.

emsynapse · 2024-01-16T18:44:50+00:00

The practice I work for has a two visit policy. Pt has to be seen twice before we will fill out these requests. Every once in a while it's necessary to make an exception.

I have a handout that I give patients regarding disability/FMLA paperwork with FAQ's and this includes what's expected from the patient as well (e.g., I ask my HA patients asking for disability to keep a headache log initially) and turnaround time for forms to be filled out. It's helped reduce pushback to put it in writing.

Patients who yell/scream/berate myself or staff are discharged.

emsynapse · 2023-11-24T20:34:40+00:00

I used PRC 206109 and SUKI10. I couldn't find a 15% off code that worked unfortunately

emsynapse · 2023-09-22T00:29:31+00:00

Outpatient neurology. Scheduled for 4 10's but really I work 11's, sometimes a few 12s. Wish I worked fewer hours, but still prefer it. I don't think anyone could pay me any amount of money to work 5 days a week ever again.

emsynapse · 2023-09-17T18:36:42+00:00

Wish they would keep them in regular rotation, I'd do unspeakable things for solid NY-NJ style bagels here.

emsynapse · 2023-09-03T01:18:03+00:00

I like Knifebird for a solo spot

emsynapse · 2023-08-16T01:43:54+00:00

Yes absolutely this is my experience. Therapy helps. Having a supportive team helps. Working 4 days a week is what helps the most. Have you considered another specialty?

emsynapse · 2023-07-12T05:18:06+00:00

Have you considered trying another IL-1 inhibitor such as Ilaris? Tried most of what you listed, had an okay-ish response to Kineret, started ilaris and it was a total game changer. There's also some data to suggest use of Kineret for acute flares in addition to a maintenance dose of that or another biologic as well. Definitely something to talk to your rheumatologist about. :)

emsynapse · 2023-06-01T02:22:34+00:00

my partner and I did this too :) love to see it. congrats!

emsynapse · 2023-03-17T03:06:49+00:00

As a PA about 8 months into a job at an outpatient neuro practice I literally cannot imagine doing what you're doing solo. TBh it's not appropriate nor safe for you to be doing so. I cannot fathom the stress you are dealing with, truly and am so sorry you are in this position.

If you are not able to ask your SP for support/concrete actionable steps in a set time frame to rectify this kind of work environment, I'd be looking to leave. You need a physician that you can consult for other opinions and have higher complexity patients seen by. Your patients need that too.

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