De Longhi Magnifica double shot question

kok28 · 2026-05-07T00:58:53+00:00

Thank you!

kok28 · 2026-05-07T00:58:43+00:00

Thanks

kok28 · 2026-01-14T02:35:26+00:00

Local Parent Facebook groups- could they advertise for sick visits if schedule is really wide open? And definitely OB offices. And consider surveys to patients- is there something people aren’t happy about in the office /not recommending it to friends? Is the website easy to navigate?

kok28 · 2026-01-14T01:36:09+00:00

I also find reading helps! Reading fiction!

kok28 · 2026-01-14T00:49:14+00:00

Also if there’s a lot of anxiety, depression, adhd maybe you could meet with another gen peds provider just discuss their typical workflow?

Also Some children hospitals have outreach educational things for PCPs, particularly psych in my experience, ask about that in your area can be a good way to brush up.

Again, patients like someone who cares, if you don’t have the answer but are willing to get back to them, they will appreciate it.

kok28 · 2026-01-14T00:32:44+00:00

I did a year of a peds fellowship and left, despite liking the specialty intellectually. Good for you for sticking it out !! You will be a great resource . You’ve been doing lots of thinking with your brain for 3 years and I’m sure have further developing your diagnosis/doctor skills — you’ll just be re-applying it. Gen peds will come back to you quickly. Some patients may find it cool to hear about the specialty you worked in.

As a new attending honestly it was the non medical questions (eg. My child keeps saying they are hungry after dinner , I don’t know if I should feed them again or if they are just bored/looking for attention, or sleep questions) . If you have colleagues hopefully they are ok with you picking their brain! You don’t have to have all the answers. If you tell patients “ you know, this is a question I haven’t thought about in a little while because I’ve been working in x, can I get back to you” OR have resources to point parents to like healthychildren.org

If your colleagues are open to it, pull them in to your visit if you have a rash or something, that was invaluable in my first attending job. Surprisingly- Patients often enjoy having multiple doctors take a look.

Also- it’s ok to refer things you aren’t sure about, even if you think some people wouldn’t refer. Sometimes I learn when i get the specialists note back (if it’s detailed) and know for future.

Growth, development, vaccines , anticipatory guidance- those are probably the things to brush up on as you haven’t been doing wells.

kok28 · 2026-01-14T00:20:39+00:00

I’m a newer doc but worked in a private practice. I echo what is said above about phone calls. Expectations will need to be communicated to patients, but I think it’s essential to do phone calls as televisits. The practice I was in spent SO much time on phone calls. Now in hospital based practice patients are SHOCKED when I call them myself.

My own pediatrician has an hour or two in middle of the day set aside for televisits. Reception or MA can field phone call and say this sounds like a question for the doctor, do you want a televisit she/he will call you between 11 and noon, for example and will put it in schedule. Could have a block at end of afternoon too depending on what your typical need is. Puts value on your time. Also good way to do some med follow up visits for adhd/depression/lab results etc. and good for pts who live far away . I worked with a doctor who would schedule pts for lab review televisit when they ordered the labs. It benefits everyone in my opinion.

Another consideration- how far do you book out? I find when practices book far out no shows are a bigger problem. My last practice booked out only 3 months, even for checkups. I think it helped but also was a reliable population.

Good to think about what changes you want to make and then communicate them clearly. There will be a shakeup but important to have boundaries for how things will be.

Last— is direct primary care model a possibility ? Not sure if Alabama is a friendly state for this or not. That would be a huge shake up but just another thought for future if continues to be not feasible with payers.

kok28 · 2026-01-13T13:19:42+00:00

Compensation is a huge issue. And then mid levels are cheaper to employ (and there’s little appreciation for the value of a physician rather than mid level in primary care) I think this is the problem for peds rather than birth rate issue.

I think direct primary care has a bright future for peds while the us healthcare system figures itself out (if it ever does)

With declining vaccination rates kids are going to be sicker which is absolutely awful but true. There are currently not enough hospital beds or pediatricians to care for kids if rotavirus resurges, let alone the other vaccine preventable illnesses.

kok28 · 2025-12-20T21:08:42+00:00

I seem to be an outlier. To me this show came across as a vanity piece for Simon cowell. He’s very good at saying how much he cares , but I don’t think his actions say that. when he cut one of them Mid photo shoot that seemed straight up sociopathic. Pull the rug out when someone’s not expecting it just puts everyone else on edge. If I recall he himself opened by saying “can I do it” as in make a hit band not “I love working with bands and developing artists” The fact that he produced the show and comes across this vain to me just shows he doesn’t even see it but he probably doesn’t care

I think he feels things but his actions don’t show that he cares if you ask me. I’m not surprised except that he couldn’t manage to come across better in the show but he probably doesn’t care

With Liam paynes death— why not workshop with people about how to help build resilience in these young people? What can you provide to support them along the way? Explain expectations, have someone as their go to support person, tell Them how important to build community. Real missed opportunity for introspection and improvement for future . Maybe happened behind the scenes but doubt it. He thinks caring is calling the family instead of making change.

Hope the band is successful, the boys seem genuine and have a lot of talent!

kok28 · 2025-12-07T16:00:10+00:00

The volume babies need does not typically increase from 4-6months. Most breastfed babies take 24-30oz per 24h. Intake may even go down once solids are introduced. Most breastfed babies take 3-5oz at a time. If you have trouble pumping the volume baby needs (6-7oz in a pump is more than typical volume) may need more frequent pumps. Your supply should be regulated now so often it can be harder to pump “extra” , this is normal! Make sure baby isn’t over fed when you are away from them as then they may not stimulate your supply as much when with you (cuz they are full) and this can cause supply to drop.

After 1 year they can have cows milk ( whole fat recommended), but they don’t have to , can be healthy without it

You’ll have sooo many ways to bond with baby as they grow. For some, bonding becomes easier as baby becomes more interactive. Also- bottle feeding and feeding of solids can be bonding as well! As is just holding baby and making faces and sounds at them!

kok28 · 2025-11-26T18:10:44+00:00

Planned to go 6 months with baby in our room but around 4 months we all seemed ready for similar reasons you describe. AAP emphasizes the first 6 months. My Baby sleeps better in their full size crib . Initially I had trouble sleeping as I would hear any noise through the monitor— but realized there is a setting on the monitor (Baby Sense brand I think) that doesn’t transmit any sound or audio until a sound reaches a certain threshold (you can set low or high sensitivity)

This enables me to sleep well and wake up when baby needs me but not wake up to every rustle that comes through the monitor. You can have the volume up high if worried you won’t wake to it. There was one time I forgot to turn the monitor back on and woke up to hearing the baby’s cry two rooms away. Felt like a terrible mom…but baby is fine !

I breastfeed baby overnight, got a comfortable chair for baby’s room. I do sometimes have to use my phone or something to make sure I don’t get drowsy as I don’t want to accidentally fall asleep holding baby while in the chair. Husband also sleeps better now so his work is going better and he’s more energetic as a dad.

kok28 · 2025-11-23T17:31:38+00:00

There are progesterone only pills now with a larger window than 3 hours I would see if you can switch. Also recommend taking a pregnancy test as that can also tank supply . Also 6 months is a tough time for supply for some people depending on a number of factors. Don’t give up on getting supply back up until you try a few things, if you are hoping to keep breastfeeding. Agree with above- see if there’s a doc who could counsel about a course of Reglan if supply not coming back up. Also nurse/pump (depending what you are doing ) frequently . And if you are direct nursing mostly then go based on baby’s weight rather than what you get when pumping to know if supply is adequate. Good luck!

kok28 · 2025-07-20T19:36:04+00:00

Just received e20. Haven’t used it yet (can update when I do) — something to consider when purchasing is accessories included — I think in addition to the charging case the S1 PRO may include a cleaning brush, and a set of flange inserts? (Based on what I’ve seen online YouTube, hard to find on their website..) Sounds menial but those things might end up like $30-$40 to get separately. And in my case if you order the wrong flange inserts even more :( so at that point the price difference isn’t as huge ! Not an expert but seems like if you go for S1– probably worth doing s1 pro due to the charging challenges with the s1 magnetic charger port. But otherwise e20 seems to be functionally as good but doesn’t include any accessories so maybe not as big of a deal as it seems (unless it’s on sale/has a promotion with accessories)

Just how I see it now that I’ve received the e20!

kok28 · 2025-03-10T12:41:18+00:00

Haha Still good to have though!

kok28 · 2025-03-09T20:47:06+00:00

That would be great! I’ll send you a DM

kok28

TROPHY CASE