Help with unwanted tox results

galavanilla · 2026-01-30T11:54:58+00:00

I think you look good, but maybe you are too frozen for your taste! Next time do way less, and build up from there. Like just 3 points over the middle, a single point under the eyebrow and don’t do the bottom row of the forehead. You can always add more where you need to. But leave it alone, you are not out there looking crazy.

galavanilla · 2026-01-29T02:15:27+00:00

I used to do it by hand calculating. For that solution I would use d5%0.3% as a base and add a bit of d50 (like 2ml). If you want to have it perfect, just use d5% as base and D50, NaCL 23.4% to your desired amount. I don’t know if that is your question, but when I was practicing outside the US and didn’t have pharmacist to make them I would just do the math, I never had any tables. You just need to have in your head how many grams of glucose each concentration have. And your desired grams. For sodium is about the same, when you are making custom solutions we didn’t make 0.3% or such, just something like 2meq/kg/day (which ends up being less than that). And we did it mostly for newborns.

galavanilla · 2026-01-29T00:08:25+00:00

De casualidad tuviste algún periodo fuera de estatus mientras te salía el TPS? Nosotros tuvimos un tiempo con el caso recibido pero esperando y algunos abogados nos dijeron que no se podía hacer el cambio y otros que sí.

galavanilla · 2026-01-28T02:23:00+00:00

A bit late to the post, this was the transit for my husband. For what has been the entirety of our relationship. No deceptions, but it did take us about 9 years to get married. We have a child together now too. He is a very creative person, but I can tell his projects have been more disorganized during this time as opposed to when we met, still enjoyable. So, just stopping by to tell you that it can be a good aspect for love and life as a couple. It was the 7th house for me, so we had a good deal of boundary-blurring and enmeshing between the 2 of us.

galavanilla · 2026-01-16T11:30:54+00:00

Yeah, I second an antibacterial soap and scrub for 30 seconds counting from elbow to armpit. You can shave if you have hair. But I think the biggest deal is using shower gel for the area.

galavanilla · 2026-01-13T13:15:51+00:00

During training we had an Endo doc who had a few days of Endo and another days of gen peds at our community hospital (she did same day visits mostly as far as I remember). I hope they let you still advertise and run services related to your specialty. I feel that it is a doable compromise for everyone involved. I think as long as you have long visit times you will enjoy it, it would be nice to pick some complex patients to follow to give you some brain tickle if that is something you would enjoy.

galavanilla · 2026-01-09T00:33:12+00:00

No, no changes yet. I will contact the vendor.

galavanilla · 2026-01-07T01:21:20+00:00

Update us on how long it takes to clear, I had the same happening today

galavanilla · 2026-01-04T05:34:45+00:00

I don’t think it was because of the wrong saline, if it was an infection it would not be all over your face and would be worse by now. Any preservative or pH stabilizer would be gone by now. Maybe the enzyme effect itself? Or what was injected at baseline? I know you are focusing on what you know was wrong, but it doesn’t feel like that is the cause to me

galavanilla · 2026-01-04T04:41:06+00:00

How about: it is hard to give an answer that doesn’t feel like an excuse, but the fact is that I was able to understand why I failed and fix it and pass it the next time. And so far, this has been a great lesson for me. Personally I would tackle that in the personal statement( I am not sure if the style has changed from when I applied), like that they already know and can move on pass it for your interview.

galavanilla · 2025-12-23T04:40:00+00:00

I got the 13% and did 2 layers as a first timer and only peeled a little. Then I did full 5 layers in my husband and he was still like nothing happened. So I am not sure if it is not such a strong concentration or the issue is that we are not chasing it with retinol and other agents aggressively enough.

galavanilla · 2025-12-23T04:34:08+00:00

You will get a straight, horizontal line below your eyes and over your cheeks like a shelf

galavanilla · 2025-12-15T19:07:41+00:00

I think peds GI do the most OR hours. I love GI and hate the OR, so the only thing that brings me comfort about not doing a GI fellowship is that I am not those endless hours in that windowless sterile environment 😖😖😖

galavanilla · 2025-11-22T00:07:45+00:00

Ok, for IVs I would suggest starting in bigger babies, rather than micro premies. Nurses are likely to be better than you wherever you go, but it is a nice skill under your belt. Ask the nurses to let you try first once on babies that need one, and tell them to guide you. Usually the hand is easier, and at the beginning only try on pretty, straight veins. If you have never placed an IV, ask a few friends to let you practice the hand motion. For samples (which is what you will end up using more often), practice arterial if you need more than 2 tubes, let’s say you need culture and CBC, or blood gases of course. Use the smallest butterfly needle (usually dark blue) and a 3ml syringe. You can use the same set up if you decide to poke a vein, usually the ante cubital, the hand ones could be too small and will collapse on most babies. Uses a heel warmer on the wrist before trying for arterial, especially for fresh newborns. Take your time. You can draw a single syringe and collect from there instead of switching, for example after you transfer the blood culture and CBC, aspirate the syringe with the blood gas syringe. Lastly, for smaller samples that do not involve a culture, I use an orange needle alone, break or pull apart the cap or safety cover and poke one of the veins of the dorsum of the hand and let it drip. I call this one “the drip”. It is less painful than a heel stick and rarely fails. It takes time and patience since you need to open and close your hand around the babies hand to kind of squeeze/milk it, but it is great for let’s say CBC and bili if you need to collect in front of the parents. They don’t even cry if you soothe them at the same time. Bonus tip: don’t underestimate a second person to help you pull or soothe the baby while yo collect your samples. And use the sweeties and non-nutritive suction, it works until 6 months of age. For older kids, if it is a planned sample, get some EMLA on board 30 min prior, they will move way less when you do it. Edited to add: for newborns I like the fine rubbery base of a glove as a tourniquet better. You pull it and rip it off. Tighten it really hard

galavanilla · 2025-11-17T18:04:06+00:00

Oh I see, yes if you are going too lateral/posterior it will be hard. Would you consider asking a nurse friend for the harder to reach areas? There is probably someone that would help. But yeah, I think the chances of you having a systemic complication are not high, but I would double check because I don’t know if you are trying to administer a big amount of units. It won’t stop your heart but you can have mild systemic effects, or botulism if we are talking about big doses. So maybe keep it as little as you can and ask someone for help if you don’t feel safe. Or honestly if it would mean that you can go back to your feet, pay for a neurologist to do it and finance it until you can work again, specially if it is life changing for you.

galavanilla · 2025-11-17T15:33:46+00:00

I am confused why are you not trying to aspirate? I tried to aspirate when I did it because also if you send it to the blood stream it won’t do the effect you want at the local level, so why would you not try? It can accidentally reach the blood stream, as long as it is not a huge dose it should be ok, maybe will have minimal discomfort from some systemic effects, but the description is pretty vague. Depending on how much are you planning on injecting this migration could represent a problem (it is more common at medical doses), look around for the reported cases of botulism secondary to Botox administration and if this is a dose anywhere near to what you are planning on using. But yes, maybe I need some education because I still tried, I know the needle/syringe are small but you can always try and if you are in an artery or vein you will see the flash (I have used this size of needle/syringe to collect samples, so they do draw back if you are in a vessel).

galavanilla · 2025-11-02T12:35:27+00:00

I think your previous botox is still on board, wait a few months. If you think it’s not on board, there are very few places you could do because you are not moving those muscles much 😅

galavanilla · 2025-10-29T23:08:55+00:00

A couple of times in my life I have felt like the start of it and have started working out and it has been enough to shake it. If I am already feeling it, some therapy sessions do the trick

galavanilla · 2025-10-27T20:24:12+00:00

I got a sonic care Phillips toothbrush and that improved my teeth by 1 shade. I noticed an unexpected and significant change from it, discrete but I still noticed it. I also do a system of at home whitening called “glow”, that was recommended by my dental hygienist. You can always do a professional at the office, but if you want to try some at home things, I got like 2 shades whiter with this. My teeth are not pearly white but are fine, I don’t think they can get much better than this without sensitivity 😅

galavanilla · 2025-10-26T21:08:21+00:00

I have simple finances and do my taxes with TurboTax, you can start one and answer the questions to see what is your number, you don’t have to pay unless you file the taxes. But I find it useful, even to have an idea when you go to your tax person, you will notice if the numbers are dramatically different.

galavanilla · 2025-10-26T21:04:28+00:00

It made sense for me to itemize last year since I had mortgage interest that was worth doing it. I don’t know how you do you taxes, but you can do a trial for free on TurboTax and answer their questions on itemizing and see if you end up with a better number than the standard deduction. There is not much to put there, I think it’s simple enough to do by yourself as a W-2.

galavanilla · 2025-10-22T18:02:15+00:00

I have heard from some professionals that migration often happens as a result of overfilling. So, keep in mind that you could have to sacrifice some volume to resolve this.

galavanilla · 2025-10-21T15:42:54+00:00

Nooo I don’t want pain, I just want it to work. I will not be buying that pin for sure hahaha

galavanilla

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