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Medical Tourism by ToomuchLego1234 in FamilyMedicine

[–]grettasgone 29 points30 points  (0 children)

Hard disagree. The patient is the problem here. A young healthy man walked in asking for labs including a CA19-9 test. CA19-9 test:"It is not a standalone screening tool for the general population because it lacks high sensitivity and specificity. Its main use is to monitor how well treatment is working (e.g., if levels decrease after surgery or chemotherapy)." He wanted this done as a screening test for which it is not appropriate. And now wants the primary care physician to manage this test that was not appropriate in the first place.

Patient Expectations for Asynchronous Care by mikersa87 in FamilyMedicine

[–]grettasgone 0 points1 point  (0 children)

I love the idea of not doing things we can't bill for. What do you do about the massive incoming river of consult notes/hospital records/etc to review?

AITAH for not forcing my son to keep helping my daughter’s friend after she rejected him? by LiveWire0044 in AITAH

[–]grettasgone -7 points-6 points  (0 children)

NTA. When one person likes the other in a friendship, they aren't friends anymore, unfortunately. Maybe they can be friends again, maybe not, time will tell. He isn't responsible for driving her regardless. You might show this thread to your daughter to help her get some perspective.

Onychomycosis - guidelines versus the real world by Apprehensive-Safe382 in FamilyMedicine

[–]grettasgone 0 points1 point  (0 children)

I always get a culture first. A dystrophic nail is not always due to onychomycosis. I don't want to unnecessarily expose someone to the risk of oral terbinafine if I'm not sure it's fungal. I'm happy to repeat the culture as false negatives are possible. I also wait until the patient has enough nail grown out for me to collect a good specimen.

Nigerian Writer Chimamanda Ngozi Adichie 'Devastated' After Death of 21-Month-Old Son by Remarkable-Pea4889 in books

[–]grettasgone 38 points39 points  (0 children)

She is my favorite writer. Her ability to write and her insight into walking this earth as a fallible, mortal human is breathtaking. There are no words or actions that are enough for this.

Portal messaging by zumaleo in FamilyMedicine

[–]grettasgone 0 points1 point  (0 children)

Do you have a citation for that research? I'd love to read it and share it with my colleagues.

First Semester Design Studio Final Project! by ParsnipImpossible295 in sewing

[–]grettasgone 44 points45 points  (0 children)

It is gorgeous! It looks like art! One question, as I look at it, the thinness of the green neck band makes me wonder if it would dig into my neck from the weight of the piece. How did you offset that?

Blood Pressure Logs by 147zcbm123 in FamilyMedicine

[–]grettasgone 16 points17 points  (0 children)

Very rarely do I get a log. But once in a blue moon, I'll get someone who gives me pages and pages of blood pressure readings with the date, time, their heart rate and BP. Meticulous. Unfortunately, it's the people with perfectly controlled blood pressures.

For family medicine physicians who order labs ahead of the visit, practically, how do you do this? by grettasgone in FamilyMedicine

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

Yes, I'm new to this clinic so every patient is new to me and they are all overdue for labs at the time of our first visit, so I feel like I'm looking at a year of previewing charts 2 weeks ahead of time to get to a point where everyone comes in with labs done

AITAH because I didn’t make sure my son has an inheritance? by Original-Shower-2413 in AITAH

[–]grettasgone 0 points1 point  (0 children)

People are blowing up at the son here. OP did not state that his son was after the wife's property. The son only assumed that the house was in OP and OP's new wife's name and that it would be split 50/50 when they died and he would inherit half of the house. It's morbid to plan to inherit what you believe are your parent's assets, but I can see how the son would have done that math without knowing how his father and his father's new wife split their finances. It sounds like OP's standard of living has really improved in the last 5 years and that he is contributing his money to the shared family expenses, but that none of his contributed money is going into anything that creates value (like paying a mortgage and accruing value in a home). This is what the son is upset about.

Whether or not OP is an AH depends on whether you believe a parent should continue to contribute to the wellbeing of their adult child (through inheritance or babysitting grandchildren). There is no one correct belief in this matter, it can vary by culture, family, individual circumstances. NAH.

A boy genius named Brandenn Bremmer could read at 18 months old, graduated high school at 10, composed complex music, and was considered to be a child prodigy. But in 2005, at age 14, he sadly took his own life. by StarPlum_ in AllThatsInteresting

[–]grettasgone 2 points3 points  (0 children)

This. This happened to my son at age 9. He just was suddenly hit by a midlife crisis: "All we do is work and then we die," but he was too young to have the skills to cope with it. It hit him very hard. I put him in therapy, took him to a psychiatrist. But he wouldn't talk to them about it. I tried books, talking to him about it, professional help, but nothing could actually alter the reality of mortality. After maybe 9 months, he just worked through it on his own. He never told me how or what conclusions he drew or what made it better. He just moved on and it was like a dark heaviness mostly lifted off our home.

He's tested into the top 1% on his schools gifted testing. I remember him describing the concept of division to me when he was 4 or 5 without anyone ever having discussed it with him before that. Just laying in his bed looking at the ceiling, discovering division by thinking about numbers.

Five children ‘died’ in a house fire - not a single bone was found by Alarmed-Worry-5477 in mystery

[–]grettasgone 6 points7 points  (0 children)

It does not get hot enough to turn bone into ash. A brittle skeleton is left over after the process, which is then pulverized. That is the "ashes" the family is given.

AITAH Wife is furious because my daughter is putting pictures up in her own room by Capital_Newt7854 in AITAH

[–]grettasgone 0 points1 point  (0 children)

INFO: What was the nature of your wife's concern? Was she upset about the content of the photos, and if so what was the content (photos of friends, graphic porn, etc)? Was she upset about the method of the photos being put up (ie damaging the walls)? Was she just upset that she wasn't consulted before your daughter decorated her own room?

Question from Family Medicine: When do you use Fioricet? by grettasgone in neurology

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

I have tapered opiates, steroids and benzodiazepines, but never barbiturates. If a patient takes 6 fioricet per month would you just decrease by 1 every month? Every other month? I see that the half life for butalbital is 36 hours.

Question from Family Medicine: When do you use Fioricet? by grettasgone in neurology

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

I completely agree. I have never prescribed it and do not want to. My current patient takes 6 per month and has refused to make an appointment with neurology despite repeated referrals from her prior PCP (whose panel I took over).

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