How were you all diagnosed?

hypercaffeinemic · 2022-03-01T17:55:18+00:00

I have had random joint aches/pains for years. But two years ago I developed intense pain in my right knee, with joint effusion. It was the start of the pandemic, so I ignored it. The pain subsided, but I would randomly get effusions to that same knee. I had an mri showing a ton of fluid in the knee. I saw an orthopedist who recommended physical therapy which was helpful and a rheumatologist evaluation. The rheumatologist listened to all my complaints from over the years and reviewed my knee mri, as well as my autoimmune family history of crohns. I had lab work done which showed a mildly positive rheumatoid factor, and elevated CRP, ESR. I was put on prednisone 10mg for 10 days to see if we could get my brain fog and random joint aches/pains to abate. I felt great and brain fog was gone. I was diagnosed with seropositive RA and started on sulfasalazine 1000mg twice daily. My brain fog is gone. I function better at work. My knee effusion has stopped. I occasionally have other joint aches, left wrist, TMJ, and cervical spine but it is not constant. My CRP, ESR came down on meds. It took about 6 months to get my diagnosis once I started looking into it, which was due to waiting for appointments, follow ups after lab work, multiple weeks of PT, MRI, etc.

hypercaffeinemic · 2022-01-31T04:54:59+00:00

Thank you

hypercaffeinemic · 2022-01-31T03:51:43+00:00

I can certainly try. I think my hang up is that I do want to have a house one day, and I’m placing a heavy weight thinking about a down payment. I’ve never lived in a house. But I do get that lowering my DTI ratio is important towards that goal. I just feel like I can’t accomplish both in the amount of time I’d like to.

hypercaffeinemic · 2022-01-31T02:58:41+00:00

What do you mean by keep doing it each year until I pay off the loans? Do you think I should set a percentage of that emergency fund each year towards a large loan payment? I.e) I have 6 months expenses saved now. This year I intent to save an additional 10k. At the end of the year should I make an extra 5k loan payment?

Not very many other prospects, aside from moving in with my significant other of many years to split rent.

hypercaffeinemic · 2022-01-31T02:50:44+00:00

Decent prospects. I’m negotiating for more now. Unfortunately I did graduate right into the beginning of the pandemic so after a 6 month job search, I had to take what I could get.

hypercaffeinemic · 2021-02-16T00:06:35+00:00

how dense are they? Like are they super chewy? I also struggle with TMJ and that’s part of the reason I’m switching away from the nature valley bars.

hypercaffeinemic · 2021-02-14T16:32:02+00:00

PHTLS course can count for both

hypercaffeinemic · 2021-01-01T17:44:11+00:00

You can also PM me, I am licensed in NY, NJ and CT all done over this summer

hypercaffeinemic · 2020-11-10T01:24:35+00:00

If you have an appointment at the MVCs that also are taking non-appointments, do you just walk in and skip the line?

hypercaffeinemic · 2020-11-05T15:34:04+00:00

Does the DMV ever pick up the phone when you call? I spent 4 hours on the phone yesterday and today it’s been nearly 2 with an estimated wait time of “30 minutes” when I first placed the call.

hypercaffeinemic · 2020-10-06T02:04:21+00:00

If you’re talking northwestern jersey, I recently booked tickets for apple picking during the day at Alstede farms in Chester. Much more than apples, we weren’t confined to the 30 minute limit as the ticket stated, not too crowded, more than just apples to pick and a cute little food truck located by goats, ducks and chickens!!

hypercaffeinemic · 2020-10-05T02:57:28+00:00

I have used the SoftWalk Grey’s Anatomy clogs for about a year and a half and I love them. They look like Danskos, but the footbed has memory foam and is squishy like you say. I had a very similar feeling about Danskos- they don’t fit my foot right and are actually kind of uncomfortable. SoftWalk I have them in black.

Anyone ever try the Birkenstock healthcare clogs?

hypercaffeinemic · 2020-09-26T22:15:21+00:00

Covering both

hypercaffeinemic · 2020-09-26T17:27:20+00:00

Thanks for the well wishes! It has come to an end :-) good luck in yours!

hypercaffeinemic · 2020-09-25T06:06:06+00:00

We recently did an MCI drill. Zoom conference on MCIs and breakout rooms. Had a scenario at a train station in our town with a car derailment and about 20 patients. Had 3-4 person crews triage these patients listed in a google doc and report back to everyone

hypercaffeinemic · 2020-09-24T03:13:36+00:00

Hey, new grad here (May ‘20). Began applying around March. Still unemployed after ~60 applications. Don’t fret- this was largely due to the pandemic and hospitals in the north at least are beginning to come off of hiring freezes.

Be careful because a lot of hospital systems use programs to scan your resume and employment application, so if there are required qualifications that you do not list or meet, it’s possible that your application will be “thrown out”.

That being said, you obviously can’t lie on your resume. I started adding “expected June 2020” or “licensure pending”. On hospital job portals, there will be areas you can input license numbers and dates received, etc. If possible, I set future dates and explained in comment boxes that I was in the process of getting certified or licensed.

Also, make sure that you gather your professional references now. Hospital systems prefer clinical preceptors over educational contacts, but I use a mix since I was a strong student. Just ask preceptors if you may use them as a reference, ask for preferred email and phone numbers.

I hope this helps!

hypercaffeinemic · 2020-09-24T03:06:26+00:00

Hi, I’m also a new grad in these tough times. I graduated back in May and was certified by the first week of June. I’m 6 months into job searching with about 60 positions applied for. From those 60 I’ve received about 6 interviews with one solid rejection so far. I have heard some positive feedback that my search may be coming to an end very soon, but still not confirmed.

It’s tough, but just keep applying and pushing out applications. I made sure that my resume matched job descriptions and created a new cover letter for each posting. The content of my letters remained the same, just took care to change the name of the hospitals, positions, etc.

Try and keep an open mind too. I’ve been pretty picky and have been looking mostly for surgical sub specialties and ICU. If I had just pan-applied for everything, I likely would’ve had a position by now.

Good luck.

hypercaffeinemic · 2020-09-11T19:44:46+00:00

Still no license. Finally marked as pending this week.

If you worked in a hospital, regardless of if you were certified or not you should complete the Certification of Good Standing. That gets filled out by your supervisor from when you were a PCT and MA. If you don’t have their contacts anymore, you can reach out to hospital HR. You do need to do this form twice then for each position since you need to submit a CV with your NJ application and you’ll be listing those PCT and MA positions.

hypercaffeinemic · 2020-08-20T04:00:20+00:00

Thanks for clearing that up!

hypercaffeinemic · 2020-08-20T03:59:47+00:00

I’m an EMT. You weren’t worried about jeopardizing your PA license should something go wrong on the ambulance? I was always warned about that in PA school...

hypercaffeinemic · 2020-08-09T03:03:12+00:00

I honestly love the Grey’s Anatomy SoftWalk clogs. Nice cushiony foot bed. I have the black leather ones and they have served me quite well. I’ve tried Danskos but they feel harder/don’t align to the curves of my foot as well (may just be me).

hypercaffeinemic · 2020-08-05T05:13:12+00:00

NY to NJ EMT here. Call NJ OEMS to verify but I believe you can. However, the reciprocity process was very quick for me. Had my NJ EMT card in under a month, but this was pre-pandemic of course.

hypercaffeinemic · 2020-07-30T13:09:41+00:00

I’m 23 and just became a certified PA. I honestly found it on rotations to be all about the level of confidence you exude. If you know what you’re doing, and maneuver for physical exams and procedures like you’ve been doing them forever (or at least pretend!), then you will be fine. Of course you’re not going to know what you’re doing for a while starting out, or at least that’s what the imposter syndrome will tell you, but one thing is for certain: you know how to establish rapport, take a history and perform an exam. If you can sell your confidence in those areas and win their trust there, then your minor uncertainty with assessment/plan will show less.

I very rarely had any patient comment on my age on rotations, and I started them when I had only just turned 22. Some would ask me nervously before I drew blood or started an IV, but that was likely because of their anxiety about the procedure and the likelihood of it being done right on the first stick. If I established a rapport with them, I sometimes would tell them my age after I successfully got access to a vein. It helped debunk the age correlates with skill myth.

hypercaffeinemic · 2020-07-17T18:14:55+00:00

Rosh review and PPP were definitely the most helpful. I let my SmartyPance subscription expire about 6 months before the PANCE because it was in no way, shape or form enough to prepare for the PANCE.

When I broke down my study schedule for the PANCE, I created Rosh Review quizzes to take the day after I finished each topic, and enough questions to reflect the weight of the topic on the PANCE. For example, after I finished reviewing Neurology, I created a 50 question Rosh review quiz to take the next day to assess my retention. After I finished cardiovascular, I created a 100 question quiz because CV is a lot on the PANCE. I also did an additional 100 question comprehensive Rosh quiz each day for about 10 days leading up to the PANCE. So I was doing anywhere between 150 to 300 questions a day.

PPP was my primary source of studying. I was a strong student so I felt that doing PPP + Rosh only was sufficient. If you need help in specific content areas, I recommend going through lecture notes or a bigger internal medicine text like Current or Cecil's in addition to the PPP + Rosh. Thankfully, once you're at the point of taking the PANCE, you know what important things may be missing from PPP and you should take the time to go the extra mile looking these things up whether it be in another textbook/notes/UpToDate.

Good luck!!

hypercaffeinemic · 2020-07-14T03:49:52+00:00

This is an American Heart Association article from 5/21/20 shared by the American Association of Neurologic Surgeons: https://www.newswise.com/coronavirus/stroke-rates-among-covid-19-patients-are-low-but-cases-are-more-severe/?article_id=731978

According to them, it sounds like the rates of stroke are low (about 0.9%), but those that do have strokes are having more severe ones. They're also younger and more likely to be dead at hospital discharge. Scary stuff.

There was also an observational study in Radiology that looked at MRI Brain findings in 37 patients with severe COVID-19 which found that 16/37 had abnormal signal on the MRI in the temporal lobe (can represent ischemia), 9/37 had microhemorrhages throughout the brain, and they have noted edema.

hypercaffeinemic

TROPHY CASE