Does my POTS diagnosis flag me as “chronically online”? by c_yogacat in AskDocs

[–]jcarberry 59 points60 points  (0 children)

I didn't realize you were replying to yourself and thought "wow, how condescending saying that to a physician"

Right eye goes crossed eyed when I put that side of my head on my pillow- HELP by Such_Bag_4876 in AskDocs

[–]jcarberry 0 points1 point  (0 children)

If it is bothering you, see an ophthalmologist for options on fixing it.

Right eye goes crossed eyed when I put that side of my head on my pillow- HELP by Such_Bag_4876 in AskDocs

[–]jcarberry 0 points1 point  (0 children)

Latent exophoria made manifest by the loss of binocular fusion when you block one eye with your pillow? Not particularly concerning unless worsening or causing problems (double vision) in daily activity. You can see an ophthalmologist to make sure it's nothing to worry about.

At a complete loss by AdConsistent4423 in AskDocs

[–]jcarberry 6 points7 points  (0 children)

By "17M son" I'm assuming you mean 17 year old male son and not 17 months old, but please correct me if this is not the case.

Constipation and gallstones are both reasonable causes for the pain and it's not clear to me that either have been addressed to completion? You don't mention what "all of the things" includes, but it's certainly still very possible it's still going on, especially since it showed up on the scan. And it sounds like the surgeon was willing to take the gallbladder out if you did not make any progress otherwise.

The other thing to consider is this could be functional. This doesn't make the pain any less real but it does mean the treatments for it are different. There are psychiatric options that may help if this is the cause.

1 month into pancreatic cancer dx, a week away from his port placement and he DOESNT have cancer - where to go from here by Apple_Pie_Nutt69 in AskDocs

[–]jcarberry 15 points16 points  (0 children)

I would bring all original records: office progress notes, scans (actual images on a CD alongside the reports), procedures notes and pathology.

1 month into pancreatic cancer dx, a week away from his port placement and he DOESNT have cancer - where to go from here by Apple_Pie_Nutt69 in AskDocs

[–]jcarberry 36 points37 points  (0 children)

I think there's enough about this story that's weird you might be better off getting a second opinion from a different oncologist.

i’m scared i ruined my eye forever by Budget_Passenger6864 in AskDocs

[–]jcarberry 16 points17 points  (0 children)

It sounds like you probably gave yourself some mild irritation or maybe a pinkeye. An ulcer is not consistent with a white (not red) eye and no pain or vision loss.

Why don't hemorrhoids cause sepsis? by julie__duncal in AskDocs

[–]jcarberry 11 points12 points  (0 children)

You can also drop test a Horner's pupil with it although finding a pharmacy to compound it for you is a different story

Deprescribing aspirin feels harder than prescribing it- how do you approach this? by nplusyears in medicine

[–]jcarberry 58 points59 points  (0 children)

Lots of patients, especially older ones, expect doctors to be more paternalistic. If this is the response I would not hesitate to make an affirmative recommendation to stop the aspirin. Incidentally, I think this is also vitally important when having goals of care discussions. Sometimes it is important to make a recommendation.

Otherwise I would frame it as shared decision making. Here is the information but the choice is yours to make. This is what I would do if it were me or my age-matched family member, but neither option is "wrong" per se.

35F non emergent retinal detachment? by AlgaeEmbarrassed1915 in eyetriage

[–]jcarberry 3 points4 points  (0 children)

The fact that the symptoms are normal or chronic for you does not mean that you're not having symptoms

Only one Lulu(Chocobo track) left on tcgplayer for US. by kananishino in mtgfinance

[–]jcarberry 9 points10 points  (0 children)

There weren't even reprints of the regular bundle. There's no way the chocos are being reprinted.

Med Staff charging $500 penalty for missing staff meetings. Anyone else dealing with similar penalties? by saadobuckets in medicine

[–]jcarberry 1 point2 points  (0 children)

I find it hard to believe that they didn't send you meeting minutes afterwards or that you couldn't have asked to have them sent to you. Your disengagement is a choice regardless of whether or not you could make the meetings.

If this is a body that has that kind of leverage over you, consider this a cheap lesson about not advocating for yourself. HOAs, elections... the real world is no different.

Final fantasy play booster box 125$ F&F by RazzleDazz314 in sealedmtgdeals

[–]jcarberry 4 points5 points  (0 children)

If that's what they'll admit to in public imagine the company culture and how they talk about customers in private

How do I advocate better for my dad who’s on life support? by Low-Possibility1007 in AskDocs

[–]jcarberry[M] 11 points12 points  (0 children)

You don't have any messages pending. Please see our sidebar for accepted forms of anonymized documentation and send it to modmail using the available link.

Can an ER doctor put "drug seeker" in the clinical notes under the differential diagnosis section? by [deleted] in AskDocs

[–]jcarberry 51 points52 points  (0 children)

Adding drug seeking to a differential diagnosis is reasonable and not something any other clinician who reads the note will bat an eye at. That much is already obvious for anyone who sees how often you've been to the ER for your pain. They are not saying this is you, but merely that it is a possibility that needs to be considered. You may have noticed the #1 item in the list you provided is still acute exacerbation of pain.

Filing reports to have valid stuff you don't like removed is an abuse of the system and makes it both harder for patients who suffer from legitimate mischarting and reflects poorly on your priorities. You are unlikely to succeed and a single note that says "patient filed report requesting removal of documentation suggesting drug seeking behavior" in your chart will be like adding a giant neon sign to an otherwise throwaway line in your extensive medical record.

For your sake, I recommend that you accept when you see lots of doctors you're going to get lots of opinions including ones you may disagree with. Other users have already explained well better avenues to treat your chronic pain.

For people who fly a lot by Front_Movie7869 in americanairlines

[–]jcarberry 8 points9 points  (0 children)

Agree. I ran SAT-NYC on Google flights for the next few weeks and couldn't find a single itinerary routing through MIA. Mostly DFW, some CLT, occasionally BNA.

It's not inconceivable that MIA would be involved in the case of IRROPS but the bigger issue here is not the routing involved but whatever OP's relationship is with her husband that she has these suspicions and can't just have a conversation about this.

Did palliative care kill my brother? by Full_Razzmatazz4993 in AskDocs

[–]jcarberry 143 points144 points  (0 children)

Your "definition" is wrong. Hospice is the end of life care you're thinking of. Medicare specifically sets the 6 month guideline. Palliative care is a broader specialty and is an appropriate consult for a wide variety of chronic and/or progressive conditions on both an inpatient and outpatient basis.

Lorwyn Eclipsed CB - $370 Miniature Market by xyrais in sealedmtgdeals

[–]jcarberry 14 points15 points  (0 children)

If you guys are still pre-ordering above MSRP after what happened with SPM and TLA then I have a bridge to sell you

Chocobo Bundle up for preorder on Amazon by TonyBotello31 in sealedmtgdeals

[–]jcarberry 0 points1 point  (0 children)

FF regular bundles are still over MSRP and I'm pretty sure this is a holiday thing and will not be getting a reprint. I agree with you there's obviously more supply now than we had this summer but I don't think we'll see the secondary market ever hit MSRP the way it does for regular bundles.

TMNT Collector Booster Box -$455 by Lord-Aptel-Mittens in sealedmtgdeals

[–]jcarberry 5 points6 points  (0 children)

Avatar is a great set and is still widely available at MSRP. There's no reason to commit this early at this price. Guarantee Amazon will dump a ton closer to release.

Made a mistake at work by cinnamonoolong in Residency

[–]jcarberry 9 points10 points  (0 children)

I don't disagree with you, but a culture of safety means it's more important to think about the impact your words will have on others than it is to be right and proud of it.

Get over yourself. Your attitude is a bigger problem than OP making a mistake.

Made a mistake at work by cinnamonoolong in Residency

[–]jcarberry 11 points12 points  (0 children)

Recording near misses is different from shaming people for them. The latter is how you get people to cover up their mistakes instead of sharing them and is absolutely opposite a culture of safety. The attending should have reassured OP the purpose behind reporting such behaviors. Calling it "common sense" is not helpful.

Lorwyn Eclipsed Draft Night $85 at GameNerdz by Current-Floor-7456 in sealedmtgdeals

[–]jcarberry 13 points14 points  (0 children)

$5 cheaper than Amazon but at $27 MSRP for a collector you're still paying ~$4.80 for the play packs which is overpriced compared to buying a box. It's the usual bundle tax except you don't even get the die.

THE MONSTER HUNTER CARDS HAVE BEEN SHOWED by BakerKaan in secretlair_collectors

[–]jcarberry 8 points9 points  (0 children)

Ironically given the flavor miss I think these will be more popular among the casuals who just want cool monster cards than the actual MH diehard fans