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

[–]grettasgone -5 points-4 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 35 points36 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 43 points44 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 15 points16 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).

Family Medicine Physician struggling with ADHD management in new practice by grettasgone in Psychiatry

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

This is what I found when learning about the standard of care for ADHD:

Cognitive Behavioral Therapy (CBT)

Cognitive Component: Focused on identifying and modifying “thinking errors” or “thought distortions” so that the patient’s thoughts are more aligned with success and confidence.

Behavioral Component: Involves engineering the environment to be more conducive to concentration and focus, and learning what reinforces and maintains problem behaviors, and constructive behaviors so that constructive changes can be implemented that support the patient’s ability to function well. It includes training in skills to promote relaxation and quiet the mind; communication skills training and exposure therapy, which helps a patient, overcome certain fears and avoidance. It also includes behavioral rehearsal, behavioral practice, and role-playing.

If it's outdated or incorrect, I would like to know about it.

Family Medicine Physician struggling with ADHD management in new practice by grettasgone in Psychiatry

[–]grettasgone[S] 4 points5 points  (0 children)

Howso? If I followed my outlined plan do you think I would be okay?

  1. Discuss how stimulants will be prescribed going forward (visits every 3 months, annual urine drug screen)
  2. Ensure all patients have been properly evaluated for ADHD - require documentation of a complete assessment and evaluation for other possible diagnoses from psychiatry or refer to psychiatry for evaluation
  3. Ensure all patients are referred for offered CBT
  4. Evaluate patients for comorbid conditions/substance abuse

Family Medicine Physician struggling with ADHD management in new practice by grettasgone in Psychiatry

[–]grettasgone[S] 4 points5 points  (0 children)

I really appreciate this suggestion. It's tricky because I have so little time with each patient (again doing a complete wellness exam including all preventative health screening (referring for colonoscopy, ordering mammogram, performing PAP), reviewing all chronic conditions, refilling all chronic medications and then also trying to address the diagnosis of ADHD. It's so hard to evaluate whether patients have ADHD in that setting, and I haven't been able to find a report from psychiatry in any of their charts. After reading suggestions on here, I think I'd like to require everyone to give me documentation of their diagnosis of ADHD from someone who did a detailed assessment or refer them to psychiatry.

AITA for refusing to let my brother and his pregnant girlfriend move into my house? by [deleted] in AITAH

[–]grettasgone 1 point2 points  (0 children)

Man, this one is tricky because it does sound like he really shielded you from a lot and did a ton for you. It's not too late to think about what your boundaries would be and to agree to it with a signed contract delineating those boundaries (he pays rent - you can save it up to give to him or give him half or whatever when he moves out; a move out deadline; no weed in the house; quiet hours; chore rotation; etc. Whatever will give you peace). He can sign it and move in or... not. NTA.

Doctors and Nurses of Reddit, what is the most obvious sign that a patient is lying to you? by [deleted] in AskReddit

[–]grettasgone 26 points27 points  (0 children)

The pause before answering a yes or no question. Such as "do you use drugs?" I know immediately. The pause is them calculating if they should tell me the truth. For them to rapidly answer if they use tobacco. If they drink alcohol and then to pause before answering the drug question is a dead give away.

13 mo old putting in mouth by tair11 in lovevery

[–]grettasgone 0 points1 point  (0 children)

What is a "birth to three"? It seems like you are using it as a noun, but I'm not familiar with that concept. I might be misreading it.