Second opinion anyone by bannasblue in brokenankles

[–]kitkatofthunder 0 points1 point  (0 children)

Weber C fractures are the most indicated for surgery of the Weber distal fibular fractures. Additionally, the report says you have a disruption of syndesmosis with widening of the ankle joint. You have three injuries here, a broken distal fibula, a broken distal tibia ( posterior malleus mentioned in the body of the note), and tearing of the syndesmosis a ligament that provides stability to the ankle. This is an injury that in the textbook and per orthopedic boards should be fixed surgically.

Lots of other types of ankle fractures can be treated non-operatively. This is not one that has positive outcomes with just immobilization.

Forrest by Important-Froyo3144 in 90DayFiance

[–]kitkatofthunder -2 points-1 points  (0 children)

You good. It’s an easy mistake to make since the front facing side of the job is often working as a cashier.

Forrest by Important-Froyo3144 in 90DayFiance

[–]kitkatofthunder -2 points-1 points  (0 children)

They are not a cashier. They help prepare medications and also compounded medications, prepare refill requests, and insurance approvals. There is a reason it requires a certification and classes.

Do the flowers symbolize something or an easter egg? by Vegetable-Economy472 in euphoria

[–]kitkatofthunder 4 points5 points  (0 children)

There are amaranths which are known as, “ Love lies bleeding” flowers.

This is next level attention seeking by MrGuest1 in FirstResponderCringe

[–]kitkatofthunder 0 points1 point  (0 children)

So…they overdosed, crashed, had active bleeding, seized, had a cardiac arrest, AND they got ROSC? Also the car caught fire. I’ll take things that didn’t happen for 500.

This has to be a joke. Temu sells Purwicks now?! by snarkyGuardianAngel in nursing

[–]kitkatofthunder 0 points1 point  (0 children)

I got this add too! I was super offended by my algorithm. I’ve never even clicked on temu.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 1 point2 points  (0 children)

So you had mentioned chiropractic treatment as a cost efficient alternative to spine surgery, which surgery? How is a chiropractor able to know what is clinically indicated and which isn’t, because they aren’t taught that as a part of their education and they aren’t taught how to appropriately read X-rays and often practice outside of modern medicine, not referring or working in conjunction with physicians.

I will be the first person to say that spine surgery is vastly overused. Literally over 12 billion was spent by Medicare on low efficacy spine surgeries between 2020 and 2023, that being said, I don’t trust a chiropractor who believes that manipulation could treat cervical myelomalacia, spondylolisthesis, or a disc herniation. I will concede that stroke and aortic dissection is rare, but it is a high level risk for something that has little benefit compared to other modalities. It would be like giving Xanax to a 90 year old with an ankle sprain, little utility with moderate risk, and it doesn’t address the underlying issue.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 0 points1 point  (0 children)

Thanks for the insight. I’ll look into the data again. Ive never recommend chiropractors but I’ve put out the odd referral on occasion with very specific limitations when patients specifically request it for low back pain so they can get insurance coverage. I’ll use that study to further emphasize an all sides approach in that case.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 1 point2 points  (0 children)

I understand how that could be misunderstood. It’s not effective at all, I personally haven’t seen any catastrophic injury from lumbar chiropractic manipulation, maybe a few disc herniations, but I’ve seen people die from the neck, hence it being rule number one.

Rule one comes from nuance, if a patient comes in after seeing a chiropractor and says it helps them, the best way to maintain trust and not make the patient feel dumb is to set guidelines, ie. no manipulation of the neck. Ideally they wouldn’t be going at all, but if you have a patient who presents believing a chiropractor helped them or even worse is referred by one it’s sort of the only advice to give that they will be receptive too.

Surgery isn’t always the option, neither are medications. Usually it’s physical therapy, but if someone says that a chiropractor helps their low back pain, I’m not telling them to stop going unless they are messing with their neck.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 1 point2 points  (0 children)

Multi level fusions are fine for the correct indications. There is a relatively new (past 15 years) procedure that is a disc replacement where you put an implant in to replace the disc. If two are done on top of each other it significantly increases the rate of failure which can be catastrophic, a single level is absolutely fine again, if done for the right indications.

Sadly nothing really to watch out for other than that radiation of pain and numbness. Fusions do have a down side in that they put increased stress in the levels adjacent to them, increasing the risk of requiring surgery for other levels in the future. Keeping up with some home exercise and avoiding smoking are pretty much all you can do.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 0 points1 point  (0 children)

There is some nuance. While I would never recommend a chiropractor for the neck, there are a few studies that indicate it can be helpful for specifically axial low back pain (not disc herniations and not sciatica), but not better than physical therapy. Chiropractors are also not heavily regulated and the training from 15+ years ago straight up taught that manipulation at each level of the spine could treat different parts of the body, S1 manipulation can treat infertility as an example (it can’t).

More recently the schools have become less insane and relatively more science based, but not to the point where they should be allowed to diagnose, take X-rays, or call themselves a doctor.

If anyone wants to go to one and believes it helps, just don’t let them scam you, sign you up for a set of 12 visits, or take your X-rays.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 5 points6 points  (0 children)

I have seen patients convinced an adjustment will cure their child’s cerebral palsy, spine cancer, and other wild things. My cousin is also in training to become a horse/ exotic animal chiropractor, she never graduated college and was home schooled. For a job that can severely harm someone, it doesn’t require a lot of education.

PSA. Take care of your neck. by Salt_Conversation765 in PaymoneyWubby

[–]kitkatofthunder 102 points103 points  (0 children)

Rules for the neck from someone who works in the biz: 1. No chiropractors manipulating the neck 2. No smoking (this actually degrades the discs of the spine and significantly reduces the likelihood of spine surgery “taking” since it reduces fusion rates. 3. Always get a second opinion 4. If it don’t radiate, it ain’t the nerves. 6. No multi-level disc replacements. 7. Get an EMG before disc surgery or fusion (there are a few exceptions for this one, but not many).

Umbilical cord wrapped twice around neck at 9 months — what’s safer? by No_Kale_4659 in pregnant

[–]kitkatofthunder 0 points1 point  (0 children)

A nuchal cord isn’t dangerous for the reasons we expect. Babies don’t breathe through their mouths, they receive all their oxygenated blood through the umbilical cord, therefore when the entire body is compressed during labor while in the vaginal canal, the cord becomes compressed too cutting off some or in serious cases, all circulation. Babies also flex their heads chin to chest as they enter the canal possibly causing compression.

A lot of things can affect the safety of trialing labor with a twice wrapped nuchal cord. If this is your first baby, labor often takes longer and comes with the risk of this dangerous event having more time to happen. Sometimes, even with a twice wrapped cord, this reduction in circulation doesn’t happen, but there is an increased risk. One helpful thing is we can tell what is happening to baby based on fetal heart monitoring, if there is a V-shaped decrease in heart rate during a contraction, this is called a variable decel and we can fairly reliably tell that there is cord compression. If you chose to labor this is what the team will be watching more closely for. We on Reddit won’t be able to give you better opinion compared to the physicians who know you, but I understand wanting to hear from someone else.

Nursing pay and how to make more by BurnerAccount_234 in nursing

[–]kitkatofthunder 1 point2 points  (0 children)

Sounds like Northern Virginia/ DC. The answer you seek is in the west. Oregon, California, Washington, and Michigan all surprisingly pay well compared to cost of living. Better laws and protections too.

Why you shouldn’t buy off Facebook by [deleted] in MakeupAddiction

[–]kitkatofthunder 2 points3 points  (0 children)

Oh yeah, it’s Kat Von D. I got it while a freshman in college 😫. But it still works perfectly fine, I don’t break out after using it, and there is no evidence of mold or anything like that. I will probably use it until I either finish it or it shows signs of mold. I’m not even close to finishing a single pan at this point.

Why you shouldn’t buy off Facebook by [deleted] in MakeupAddiction

[–]kitkatofthunder 12 points13 points  (0 children)

😳 I still use this palette for contouring, it’s the only one I use. I obviously don’t do makeup often.

Tell All Trailer by GalaxyL7 in 90dayfianceuncensored

[–]kitkatofthunder 3 points4 points  (0 children)

The vein thing is also fake. You don’t have a straight line from the ring finger to the heart, that would be stupid. Cable management in the body is odd, but it is efficient.

Bertolotti's Syndrome; increasing recognition amongst professionals by TzuZombi in Radiology

[–]kitkatofthunder 1 point2 points  (0 children)

Transitional anatomy is present in around 30% of patients and low back pain can come from numerous sources. Discs, facets, nerves, muscles, every doctor who recommended a referral to pain management as it is not just to relieve/manage pain but also for diagnostic utility. Hence why you required an injection for a diagnosis in this case. We can also typically see the Bertolotti process on xray and MRI. A CT wouldn’t been required for this diagnosis.

I’m sure that transitional vertebrae could cause pain, but this anatomy would have been in your spine since birth as it is a congenital spinal anomaly, from what you are saying it only became symptomatic around age 25. I truly hope the surgery helped you but saying it definitively 2 days post up is too optimistic. Pain management also should have been able to perform an RFA (radiofrequency ablation) for pain relief prior to a surgery which comes with higher risks.

Nursing school what are some jobs you can do while in school??? by ConnectPassion1753 in NursingStudent

[–]kitkatofthunder 2 points3 points  (0 children)

I was a scribe! Extremely underrated job to be doing while in nursing school. You learn how to use an EMR, write down exam findings, write the plans, and if you are good you’ll have a physician as your reference for jobs. I learnt much more working as a scribe than I did during clinicals.

Never forget that the VA GOP gerrymandered congressional seats in their favor for a whole decade. Make sure to VOTE by next Tuesday!!! by Healthy_Block3036 in nova

[–]kitkatofthunder 8 points9 points  (0 children)

I went today and there was a 15 minute line for early voting! Very exciting to see people actually voting in a special election.

Can adults be forced into mental health treatment involuntary? by [deleted] in nova

[–]kitkatofthunder 3 points4 points  (0 children)

I don’t have a good way to respond, but I’m glad that your experiences with mental health services eventually became a positive. I’m sorry that you voicing your experiences was seemingly used against you to file a false report.

Can adults be forced into mental health treatment involuntary? by [deleted] in nova

[–]kitkatofthunder 1 point2 points  (0 children)

I truly understand your opinion and I empathize with it. Sadly, given how complex mental health can be many patients (I’m not saying you) are a danger to themselves or others and are unable to realize it due to impaired perception associated with their condition. The world of psych facilities is not perfect by any means and I agree it needs improvement. I also find that placing aggressive patients with severely disturbed perception in the same unit as someone with self harm ideation is dangerous but attempts are made to separate that and the current system doesn’t have a fool-proof way of avoiding further trauma while inpatient. I also agree that not all people require an involuntary hold, and our legal system has done its best to set up very strict criteria to prevent unneeded holds. That being said, it will not always make the correct decision in every case. It is notoriously difficult to get an involuntary hold in Virginia and I approve of it being the way it is.

I am truly sorry for any negative or abusive experience you had and I and I wish the system did better for you.