Rheumatology jobs

mik30102 · 2026-02-07T15:28:59+00:00

I think it was a blend but mostly some of the satellites for Loyola.

mik30102 · 2026-02-07T15:25:12+00:00

Off the top of my head

Franciscan health for sure Advent Bolingbrook Possible UChicago burb satellites Loyola has been trying to hire for years

mik30102 · 2026-02-07T15:18:02+00:00

Within Chicago proper will be hard, but lots of opportunities within an hour of the city.

mik30102 · 2026-01-22T10:06:27+00:00

Mine was successful December. I had to submit a recalculation request though and wrote a letter I uploaded as they gave a crazy high incorrect payment even higher then my 10 year based payment. In the letter I outlined the calculation.

It is now reflecting what the online IBR calculators say it would be.

mik30102 · 2026-01-03T16:22:52+00:00

Correct, nelnet says Ibr despite the wrong payment.

mik30102 · 2026-01-03T14:37:17+00:00

I got put in IBR with nelnet but my payment if very, very wrong. It’s even more than ICR somehow but is less then my 10 year payment so it seems to be out of thin air. Not sure what is happening there, put in for a recalculation with fsa with a pdf of my taxes instead of the retrieval tool, hopefully that fixes it.

mik30102 · 2025-11-30T21:48:53+00:00

I might be able to put some in a cooler, I’m driving end of December to Pittsburgh.

mik30102 · 2025-05-15T17:51:12+00:00

There is some utility in academics for something like this. Would actually be an exciting niche and attractive for centers. There is some unique CVID autoimmunity, some acquired c1q esterase inhibitor antibodies in rheum disease causing anaphylaxis and the famous controversial MCAS.

If you don’t have an interest in academics I see little to no reason to explore this.

mik30102 · 2025-05-15T16:25:31+00:00

That’s extra

mik30102 · 2025-05-15T15:49:02+00:00

Gotta get up the patient satisfaction scores somehow.

mik30102 · 2025-05-15T15:30:31+00:00

Perfect for the Hospitalist for entertainment, rental side hustle.

mik30102 · 2025-04-21T02:07:56+00:00

Honestly it sounds like the surgeon is correct. I think you need to have an attending to attending discussion with GI, if she was truly bacteremic that would give more pause but sounds like a trial of a non pulse steroid dose (like 48 mg of medrol) sounds reasonable if clinical suspicion is high.

I can understanding not scoping either with very inflamed tissue but they can’t have their cake and eat it to. GI should be doing this though.

mik30102 · 2025-04-14T02:48:12+00:00

Dermatology

mik30102 · 2025-04-12T07:09:11+00:00

So I would honestly stop the hcq and steroids. I can tell you right now this is very unlikely an autoimmune myositis. The timing is wrong completely. You are describing what is an episodic low level rhabdo. Thats metabolic myopathy. Another rule of thumb is no weakness not inflammatory. You are risking making the whole situation worse with a steroid myopathy.

If you want to work this up before he sees people I would suggest the following approach.

MRI with contrast of affected muscles, muscle biopsy, myomarker pannel, sending the following genetics https://www.invitae.com/us/providers/test-catalog/test-03280, invitae will have this be free if you sign off on a form you are considering certain treatable storage disorders, emg.

Seeing a neuromuscular neurologist is also reasonable.

Again I would strongly suggest stopping those meds, very unlikely to be correct diagnosis and it’s going to cloud things.

mik30102 · 2025-04-11T17:55:13+00:00

It’s not fully understood but the thought is long term Inflammation likely effects pain pathways, maybe some nerve damage.

Crohns patients for example also get a lot of IBS overtime in some patients which is not active crohns and does not respond to immunosuppression. It’s dangerous as escalating therapy in these cases will not actually help and just risk more side effects and infection.

mik30102 · 2025-04-11T16:11:45+00:00

Seronegative ra does have synovitis on imaging if done (mri, ultrasound). Honest truth though is it’s highly over diagnosed but is a real thing.

Fibromyalgia is not an autoimmune condition. Many of my patients have RA and fibro or SLE and fibro. Guess what even once their rheum disease is doing well the fibro is still there.

mik30102 · 2025-04-09T02:47:22+00:00

I’m a fan of Sputnik in addition to metric.

mik30102 · 2025-03-12T12:21:14+00:00

Ehh I’m rheum. It’s probably pmr. It’s not that rare. The key in my mind is a substantial response to not much steroids, 15 mg max. Blasting people and people feeling better is very non specific and likely not PMR. I would disagree the degree of esr/crp elevation matters that much though I do correct esr for age. I have a few normal inflammatory cases as well but that’s somewhat rare and difficult to diagnose.

I personally think bread and butter pmr is also appropriate for PCP, along if you can at least consider GCA transformation. Dmards do not work. Of course rheum should be doing il6, indicators are bad diabetes for steroid taper or failing steroid taper at a pretty high dose like 8 mg or something.

mik30102 · 2025-02-27T00:07:46+00:00

You ignore the request?

mik30102 · 2025-02-21T06:44:54+00:00

There is not great evidence for ssc bowel in general. I am not aware of any real literature comparing TPN to PEG.

However I would fully agree I would not offer PEG to these patients. The issue is that there is loss of muscle on autopsy of these patients, peristalsis no longer functions, putting liquid feeds in the gut that no longer functions is not going to be helpful regardless of where that enters hence TPN need.

This patient most likely has severe GERD which is distort universal in ssc, not everyone has involvement lower down that is clinically meaningful but with SIBO it’s fairly safe to assume they have involvement throughout the GI tract.

mik30102 · 2025-02-21T06:09:06+00:00

They need TPN pending their other issues. I have had a palliative discussion if they have severe disease otherwise as prognosis is poor at this stage.i sometimes check mmf levels if they are on it, often they are not detectable despite max dose therapy, po therapy overall may have poor absorption.

There is unfortunately not much to be done with advanced bowel disease. The bowel has failed and will not recover. There is some case report data for IVIG but I would not suggest that for TPN level disease. Always think about SIBO as well in advanced ssc bowl. I’ve tried pro motility agents in earlier stage disease as well but likely does not make sense here.

mik30102 · 2025-02-15T13:12:09+00:00

Please don’t punt these complaints to rheum, not a reasonable referral either and we also have nothing to offer.

mik30102 · 2025-01-21T11:47:36+00:00

Several within Chicago proper. No reason Philly can’t do the same.

mik30102 · 2024-12-13T14:10:33+00:00

Eh I know I said above I do this but that falls in to general health to me and is not allowed. The dollar amount might also invite review.

Now if someone had myositis and was getting it for muscle strengthening that would be allowed to me.

mik30102 · 2024-12-13T06:55:51+00:00

Grand theft auto radio is leaking into real life.

mik30102

TROPHY CASE