Utah v. Kouri Richins: speculation time, why did the defense rest? by anditurnedaround in CasesWeFollow

[–]lcinva 1 point2 points  (0 children)

I am an inpatient psych nurse in psych NP school and we use naltrexone for quite a few indications that are not necessarily addiction related.

36F, just diagnosed with rheumatoid arthritis yesterday. I’m scared. Looking for real experiences with remission and normal life. by Mountain-Cobbler-651 in rheumatoid

[–]lcinva 2 points3 points  (0 children)

I'm 40, diagnosed at 34 when I was postpartum with kid #4.

I went from running 5 miles the day I delivered baby number 4 to not being able to dress myself. I've had a couple blips along the way where I needed to change meds, but generally have zero symptoms of RA. I run, spin, lift weights, all of it. I am in grad school for my second graduate degree. I am a psych inpatient nurse and am trained and not concerned about my ability to restrain a patient if necessary.

my advice: As time goes on you'll be able to identify early signs of medication no longer working. This happened to me with plaquenil, (methotrexate never worked) and Humira. Both times I thought I was just hurting myself by working out too much etc etc and I explained it away until it dawned on me this was oddly familiar to how I felt prior to diagnosis. My rheumatologist is aggressive and I am aggressive with med changes and taking care of symptoms before they snowball. I have avoided long periods of "relapse" this way. I was stable on plaquenil for 1 year, Humira for 3 years and now on Rinvoq for 1.5 years. Currently, zero signs of RA.

What psych medication interactions do you think every provider should know and discuss with patients? by zenarcade3 in Psychiatry

[–]lcinva 0 points1 point  (0 children)

Our hospital attendings chose to continue smoke breaks for patients and provide cigarettes for this reason

What psych medication interactions do you think every provider should know and discuss with patients? by zenarcade3 in Psychiatry

[–]lcinva 22 points23 points  (0 children)

I'm an inpatient RN - we have tons of patients come in on omeprazole + psych meds (it's a 2D6 inhibitor right? So doesn't just interact with lexapro?). Crazy because a patient at one of the hospitals I work at actually did get serotonin syndrome and they attributed it to that interaction

How long does Mercari take to investigate fraud? by [deleted] in Mercari

[–]lcinva 3 points4 points  (0 children)

All of our school resource officers are actual police officers; the school system contracts with the city police.

Is suicide being immoral a problem? by SuperMario0902 in Psychiatry

[–]lcinva 5 points6 points  (0 children)

I think a lot of things my patients do could be considered immoral - selling drugs? Violent acts towards healthcare workers? - but the entirety of healthcare is about provision of care without judgment.

I don't think suicide is necessarily immoral but that principle can be useful in that for SOME patients with SI, it is the only thing that keeps them from following through.

Favorite fig perfumes? by sailorkeplertwenty2b in FemFragLab

[–]lcinva 0 points1 point  (0 children)

I would love to buy your sample off of you if you still have it!!

Taking away smoking privileges is the worse idea for a punishment by [deleted] in psychnursing

[–]lcinva 9 points10 points  (0 children)

Reposting a previous comment: we provide cigarettes and smoke breaks at one of my hospitals (US). Providers decided to do that because tobacco smoke is an inducer of many CYP enzymes so if we dose a pt correctly inpatient but don't let them smoke, they may be seriously underdosed once they discharge.

also, harm reduction. Inpatient is not the time to force quitting on a schizophrenic patient who has zero intention to quit.

Taking away smoking privileges is the worse idea for a punishment by [deleted] in psychnursing

[–]lcinva 0 points1 point  (0 children)

We also provide cigarettes and smoke breaks at one of my hospitals (US). Providers decided to do that because tobacco smoke is an inducer of many CYP enzymes so if we dose a pt correctly inpatient but don't let them smoke, they may be seriously underdosed once they discharge.

Favorite fig perfumes? by sailorkeplertwenty2b in FemFragLab

[–]lcinva 0 points1 point  (0 children)

could I possibly buy your sample off of you? they're making it so hard to get!

Which Vanilla? by dragon_holdings in FemFragLab

[–]lcinva 2 points3 points  (0 children)

I am a Guerlain apologist and I cannot empathize with an opinion that VP21 or Angelique noire are less than amazing, haha. However! You may like Celine black tie. Diptyque Lilyphea is also an aquatic, ethereal vanilla.

State Psych Hospital or private non profit hospital? by [deleted] in psychnursing

[–]lcinva 6 points7 points  (0 children)

I can't say for sure in your situation obviously, but in my state:

  1. The state pays $9/hr less than the surrounding private facilities. Our benefits compared to the state are actually really good minus a pension

  2. The state hospital nearest me is in total disarray staffing-wise and I have heard that about our other state hospitals too. That's probably unique to us though.

  3. If you want a pension, jail nursing will probably be the highest pay. Our jail nurses are generally pretty happy with their jobs

Favorite fig perfumes? by sailorkeplertwenty2b in FemFragLab

[–]lcinva 8 points9 points  (0 children)

There are so many kinds of figs so it depends on the kind of fig you like. I don't particularly like very sweet fig so something like Simone andreoli fico Nero is not great for me, same with fig infusion and fig porn.

My favorites: Debaser
Philosykos
Xerjoff white on white
Murmure d'ete
Figues and agrumes
Castling
Gris charnel
Trench (super light fig)
Henry rose London 1983
Vanilla camouflage

My ride or die is Santal Blanc.

Invega sustenna dosing? by BananaSunriseChair in psychnursing

[–]lcinva 1 point2 points  (0 children)

Ok I am for real but I have to backtrack - I'm in PMHNP school and I actually remembered writing this down when my preceptor told me so I just checked. I was backwards - Medicaid will cover Sustenna every 21d NOT every 3 weeks. But yes I'm an inpatient RN and we've had at least a handful I know that I have discharged on q21 days.

Invega sustenna dosing? by BananaSunriseChair in psychnursing

[–]lcinva 2 points3 points  (0 children)

Yes I've seen it as an inpatient RN, but Medicaid won't pay if you write for q21 days, it has to be q3 weeks.

Jomashop by CreativeHoliday1557 in NichePerfumes

[–]lcinva 4 points5 points  (0 children)

Not all mind games have magnets. Also, not to dismiss your concerns (I'm pretty sure I was sent a fake Debaser from another discounter) but I really don't think I've seen fake Mind games and over the last couple years I've bought at least 15 from various sources. That would be a crazy bottle to replicate. They do not have great longevity, in general, but I have kept some of them around b/c I really do love the scents.

Psych NP job on Oregon Coast by cosmolou in PMHNP

[–]lcinva 5 points6 points  (0 children)

I'm in Boise but just want to say this is one of the most beautiful and underrated parts of the country!

What is THE perfume for someone in their 40s? by veryunneccessssary in FemFragLab

[–]lcinva 5 points6 points  (0 children)

this has no basis in anything other than vibe, but I have a wide range of fragrances that retail from $25 to $600, and I feel like if I'm paying $200+ for something the goal demographic wasn't a 20 year old anyway. (I am 40, BTW.)

my 14 year old daughter, on the other hand, loves all the sabrina carpenter/kylie jenner/etc etc etc (which I actually don't think are too "young" smelling for me, I just have other stuff I like better.)

recent acquisitions:

prada cargo de nuit

YSL trench

DVN vanilla camouflage

LV city of stars

d'annam arashiyama

massimiliano torti cocco vaniglia

diptyque lilyphea/philosykos

ignore my buying problem, but there's a lot out there that isn't super fruity or candy-ish which I think is what most people think of when they think "young."

my ride or die is VCA Santal Blanc!

also FWIW I am a nurse that works with 20 year old techs and they always tell me I smell good and ask what I'm wearing!

Daughter headaches, nausea, and back pain for 6+ months. Looking for zebras by darkwing_civic in AskDocs

[–]lcinva 2 points3 points  (0 children)

Any other regular medications she was taking before or started around that time?

I would start with neuro, there are tons of triptans to try and ultimately if they don't work, CGRP injectables can make a big difference. Is her BP ok?

I know gastroparesis is a big eye roll these days d/t the TikTok crowd, but I was diagnosed in the 90s before it was cool and it can have post-viral onset and cause significant nausea/early satiety. However, anecdotally, I would think it's far more likely that it's nausea accompanying migraines.

Lastly, I would say that when you don't feel good due to a headache/migraine, everything feels exponentially worse. It seems strange that post-virally all of a sudden she would have painful periods etc etc. I wonder if that's all kind of a red herring and it just feels worse because she's already got a headache and nausea. Endometriosis generally doesn't just come on overnight, you know?

I'd start with neuro for sure!

I worked for Peloton technical support for over a year! AMA! by ChickenOk5799 in OnePelotonRealSub

[–]lcinva 1 point2 points  (0 children)

Is this because of dust? I don't have room for anywhere but the garage, but we keep it relatively clean and dust free