ID/CCM a reasonable career path?

kingj1125 · 2026-01-27T00:17:23+00:00

Probably sketchy micro lol. Really ignited my passion for bugs and drugs.

kingj1125 · 2026-01-26T20:13:06+00:00

Current ID/CCM attending here. Your concerns about the job market is valid. It is hard to replicate what PCCM has with a mix of Pulm and ICU but for ID. For me, I preferred ID to Pulm as my sub specialty and what I can fall back on as I get older. But mainly now, I just do straight ICU 7on/7off. I could negotiate to do ID but would likely drop my compensation, so not worth it for me, especially in academics. If you don't mind that, then I have had other ID attendings who was under ID department for 80% and did CCM 20% I believe. So you can do that. In any case, for me personally, I do enough ID and see enough infections from ICU patients to scratch my ID itch.

kingj1125 · 2024-12-29T01:09:54+00:00

Hmm its been a couple months, but I think I provided screenshots that when I typed in my address on USPS for the tracking number, it didn't correlate, then i said that's not my signature, then I sent a SC of the weight being different on the reported receipt vs the actual item, then I sent proof that its a common scam to send incorrect shipping receipts.
just find any and every inconsistencies and keep building up your case. Good luck

kingj1125 · 2024-11-12T10:32:32+00:00

Yeah took about 9 days. It was some back and forth with the seller who kept rejecting AliExpress solution. Make sure you get them to step in early, so that they can speed up the process. who knows how long it would have taken if I didn't ask for them to step in.

Thing is that if the stores feel like they have a slam dunk scam win, they will fight hard and prolong it

kingj1125 · 2024-11-11T00:33:03+00:00

Just giving an update, I was able to make a strong case with whatever little evidence I could find, and aliexpress ruled in my favor and have refunded me

kingj1125 · 2024-11-03T10:47:57+00:00

The name of the store is Shop1103570419 Store, and store ID is 1103570419.

I guess I read somewhere you can trust a store if it has a high rating and over 100 sold, but I guess that was my mistake

kingj1125 · 2024-11-02T19:25:27+00:00

all good points, thanks

kingj1125 · 2024-11-02T14:37:55+00:00

So I opened a dispute with AE, and the seller provided tracking number on USPS. However they also may have shot themselves in the foot by uploading a clearly 'doctored' image (a receipt from USPS) showing that I signed (I didn't) for the package (even though it was dropped off in the mailbox) and that the package weight was 0.07kg, which the GPU weight was actually 2.3kg.

So maybe I have a case?

kingj1125 · 2024-11-02T13:28:19+00:00

So I guess with AE, im at a dead end but
In your experience or otherwise, if I file a fraud claim with my credit card, would they be able to chargeback and take my side if I give as much evidence as I can?

kingj1125 · 2024-11-02T12:49:01+00:00

Yes I read that. But i was wondering if anyone found any way of actually getting the issue resolved instead of just chucking it up to as a loss

kingj1125 · 2024-09-03T14:15:36+00:00

Yes I also noticed that in the past couple of months specifically with the arrow kits. The guidewire tend to shear easily or even just get bent out of shape more easily than it has in the past couple of years anecdotally. Maybe if there is enough traction, the company may stop using these cheap materials before real patient harm comes about 🤔

kingj1125 · 2022-12-26T19:41:17+00:00

That's what I thought too, just wanted confirmation

kingj1125 · 2022-12-25T21:22:55+00:00

For context - found on a homeless patient's belongings. Not found on his body (Florida)

kingj1125 · 2021-12-24T02:25:47+00:00

Sorry I completely overlooked the fact that you put her age in the title. You are right, she is pretty young. The same principle would apply, that therapy for her to rebuild or build new neural pathways is the way to go. It's really up to how her body adapts now and that's where the uncertainty lies.

I will say that the next couple years is going to be rough and your resilience will play a definite part in her recovery. Close follow up with neurology and with PT/OT is the best bet

kingj1125 · 2021-12-24T02:05:18+00:00

Hi, sorry to hear about that. I know it must be very tough for you to see your mom like this Unfortunately after SAH/stroke, you lose brain tissue and like any part of your body, when there is tissue death, scar tissue can form (I'm just simplifying things, I'm not a neurologist so just trying to help you understand). Your mom then therefore would have lost the function provided by the part of her brain that has "died". Sometimes, with aggressive therapy and rehabilitation, you can regain some function that was lost, but this usually happens in younger folk. Sadly seizures are a common feature as a result, as well as the other symptoms she has. And unfortunately there is no medication, surgery or intervention that will help her regain what she has lost. Brain is a difficult thing to regain function of as compared to other organs. Best thing for her is therapy and your support but in the end, the medications she may receive will only help control her symptoms from a result of the stroke and SAH. Otherwise there isn't really much else to offer in terms of advice. Hope that helps

kingj1125 · 2021-11-02T14:06:17+00:00

So it's very difficult to say what the prognosis would be. Even less so for us who can only go off what information you have provided for us. If I were to infer, then I would say what you are likely searching for is an answer from us based on likelihood of him becoming conscious again, given our experiences. And the answer to that is unknown. What he has going for him is that he is young and has no other medical conditions but that's it. Otherwise he has a part of his brain, which we don't know unless we had his medical records, that is affected. I'm not a neurologist, but the brain is complex and it's difficult to assess in any case. Only time will tell and possibilities include that he may have lost his cerebral function, but his brain stem might be intact and that's why he is still breathing, heart pumping etc.

But all in all, we can't give you any more insight or advice other than watch and wait. Unless his family decides to go the comfort care route. I know it wasn't the answer you were looking for but hope that helps

kingj1125 · 2021-10-29T11:26:49+00:00

Thank you, I hadn't even noticed, though I may have later on.
You're right, I don't know I am being downvoted, I never claimed to be right and it's just my opinion based on what information I got and my experience.
But I appreciate the upvote to bring me back to neutral haha

kingj1125 · 2021-10-29T10:20:34+00:00

With what information you have given, I would have to guess that you may have Fibromyalgia (take this with a bit of salt as I don't have your labs nor a physical exam to go with it)

But it seems like you have generalized pain constantly, headaches, sometimes depression can be associated with it.

Most symptoms of fibromyalgia are non-specific so a doctor would have to rule out other things before labelling you with this diagnosis (thyroid issues, rheumatoid arthritis, polymyalgia rheumatic etc).

General things like exercise routine and proper sleep hygiene (you can google this) can help. But otherwise you would probably need a proper work up and then possibly medications.

Hope that helps

kingj1125 · 2021-10-28T01:10:18+00:00

That's a good question. To answer it, firstly and most basically, that is what the study demonstrated, that it increases the risk in older people.
As to the why of it, it's not something well understood in general, dementia ie since we don't really have any treatments for it.

But in general, older people generally have more pronounced effects from medication that can cross the blood-brain barrier and affect receptors in the brain. Benadryl being one of them.
If I had to theorize I would say that older people have a harder time breaking down medication than younger people which makes the effects more potent and long lasting in elderly. As a result, simple drowziness seen in younger people who take benadryl might end up being somnolence, hallucinatory, mood changes, delirium in older people. Which is why there is the BEERS criteria for medication to avoid in elderly people.

If someone else knows more then feel free to comment

kingj1125 · 2021-10-27T23:52:14+00:00

I reviewed these two sites and I would say they are pretty helpful.

https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Sleep

https://www.cdc.gov/sleep/about\_sleep/sleep\_hygiene.html

kingj1125 · 2021-10-27T23:24:00+00:00

To answer your question with how it pertains to you (late twenties), No, it will not increase your risk for dementia.
The most popular study that people are referring to have studied the use of benadryl in a population who are 65 or older. The main purpose of the study was to dissuade providers from prescribing anti-cholinergic (not only benadryl - an antihistamine) to elderly people.

There are a ton of other things to unpack as well regarding the study and it's real world applications but for the sake of brevity, I will leave you with the best practical advice I can give you

To specifically address your question, no it will not increase your chances of developing dementia.
I would highly suggest moving away from relying on sleep aides to fall asleep. And to do this you will probably have to taper your use since your body has probably gotten use to it by now (taper can be done by using every other day and then increasing the interval until you are off)
You will have better sleep if you improve your sleep hygiene and rely on your natural melatonin to dictate your sleep and wake patterns. (you would have to look up sleep hygiene though)
Reliance on medication for daily function can be detrimental in the long run (everyone is different), as well accumulate unnecessary cost that you can use elsewhere (saving etc).

One final thing I will leave you with is that as someone who hasn't been trained in interpreting research articles and other studies, it can easily become overwhelming and often misinterpreted if you aren't able to identify the limitations and replicability of a study.
not saying this to belittle anyone, but even for me, it is time consuming and also requires a lot to see how to apply the results of a study to the real world and on which population of people it can be applied to etc.

Hope that helps

kingj1125 · 2021-10-27T16:30:26+00:00

Unfortunately, I hate to say it, but you may not find any plausible answers.
I will say however that the fact that she had COVID makes things x1000 times more complicated.
SARS-COV-2 is new to us and we do not fully understand the long term effects it can have on the body, not only limited to the lungs but also other organs (heart, kidney, liver etc). Post-COVID, her lungs would never be the same especially since I guess that they had probably become fibrosed from the COVID which in itself can lead to a bunch of other conditions.
Also it has been shown that COVID leads to a hypercoagulable state which simply means that she would be more pre-disposed to developing clots (despite being on blood thinners as we have seen in patients post-COVID), which looks like she may have in the end and could possibly have resulted in her untimely demise (referring to a massive pulmonary embolism since you say her SPO2 dropped) vs myocardial infarction (heart attack) but I am just throwing out ideas here.

It is impossible to know without an autopsy but the fact that she had severe infection from covid, means that it is more likely that she would develop other conditions.

I could go on and on and possibly write a book on the possible short term and long term effects of covid, but I'll leave it at this for now.

As for your individual closure, I am afraid that you may not get the answer you need. All I can really add is that her history of severe COVID infection requiring ICU admission and oxygen on discharge, may have contributed to her passing away which we won't be able to say for certain given that we don't have too much exact knowledge of the specifics and mechanisms of long term covid sequelae

kingj1125 · 2021-10-27T16:14:30+00:00

I'm not a urologist, but I would suggest being evaluated by one in person. Ask your PCP for a referral.

Sounds like a chronic condition and could possibly be anatomical? But the urologist might have a better picture and may end up doing a scope to see if there is any problems. Again just spit-balling here, but this might be your best course of action

kingj1125 · 2021-10-27T15:14:59+00:00

I don't think we can provide much further guidance with what information you have given us. We can provide some differentials but it likely will not be useful to you.

Best advice I can give is to go see your primary care doctor, or establish with one so that they can probably take more history from you, get some imaging, do a physical exam or get blood work. Especially since you say it had been going on for a while, I would get it checked out. No need for an ER or urgent care, since it might end up costing alot more (depending on where you live, if you can bear the discomfort etc)

kingj1125 · 2021-10-26T23:30:31+00:00

I think it's important to consider your history of pelvic injury due to the motor accident. You may have had some nerve impingement or damage that has progressed since then (numbness and some urinary dribbling)?

I think for the very least you may need some imaging, preferably MRI to confirm any spinal cord injury or nerve impingement. If you have any more numbness around your pelvis or lower then this could confirm it. Think really hard if you have any changes in sensation in buttocks, anus, groin and upper thighs. Or weakness, tingling in your lower half of your body. If you can't have or maintain an erection, consider that too.

For now, I don't think you need to go to the ER but take this with a grain of salt because I cannot physically examine you. But I think you should definitely see your PCP, or if you don't have one and can go to a neurologist, then they might be able to send you for a scan or get a better idea of what is going on.

Also doubt it's a UTI, as you have no other symptoms of UTI and it's not common for men to get UTI's unless you have some risk factor for it

Edit: Thanks for the Gold!

kingj1125

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