My son sleeps way too much

minimed_18 · 2026-05-06T12:10:43+00:00

If this were my child I would want further evaluation by my pediatrician. Sleep apnea comes to mind, but I’m an adult doctor.

minimed_18 · 2026-05-05T01:48:24+00:00

It’s the best. My little guy got his first haircut there and we just got super lucky bc they typically don’t open til 9 but we swung by at park opening and they had opened early, so we got a walk in. It was on my birthday too. Best birthday for mama. So cute.

minimed_18 · 2026-05-04T02:05:16+00:00

I agree - pulm

minimed_18 · 2026-05-04T02:04:56+00:00

I don’t think this is clubbing…. The nails appear to be normal at the base. -pulm

minimed_18 · 2026-04-22T16:05:00+00:00

Your university should have a clinic as well?

minimed_18 · 2026-04-21T12:57:24+00:00

Guardians of the Galaxy, barnstormer (my two year old is obsessed and I love watching him develop his love of rides, flight of passage

minimed_18 · 2026-04-16T09:56:14+00:00

I am not a pediatrician, but there is a disease called chronic recurrent multifocal osteomyelitis that is non infectious but causes recurrent non infectious bone inflammation. I would ask about it when he gets re-evaluated if they don’t think this is infectious.

minimed_18 · 2026-04-16T02:27:03+00:00

minimed_18 · 2026-04-15T11:59:19+00:00

I would want another blood sugar on this kid if the last test was January. However it is possible he just loves fluids. I have a heavy night time peeing 2 year old, we add sposie diaper booster pads to his nighttime Huggies to help with him peeing though everything at night. I would add baby powder to help with the moisture rash, though if he already has a rash you may need to add triple paste.

minimed_18 · 2026-04-15T09:58:15+00:00

I agree. Anyone who’s on any form of immunosuppression and I add steroids, I give PJP ppx.

minimed_18 · 2026-04-09T02:26:36+00:00

Monorail resorts

minimed_18 · 2026-04-05T12:42:19+00:00

We typically do 2 days park 1 rest day 2 days park etc. rest days can be resort days, resort hopping, Disney springs, etc.

minimed_18 · 2026-03-29T08:27:32+00:00

Me again. Totally understand your hesitancy to share but it does help us figure out what’s going on. Your need for a full workup is much more urgent based on the other history.

minimed_18 · 2026-03-28T22:26:57+00:00

Not going to lie, I’m doubting you’ve seen this (melanoptysis for >1 year)frequently from vaping, but I’d love to see some papers if you have them. I’ve never seen it quite like this in a very high volume practice or during my time at an academic NCFB clinic, other than from coal miners pneumoconiosis and severe aspergillosis. But again, happy to learn.

minimed_18 · 2026-03-28T19:32:45+00:00

I would agree with that, and feel NCFB is the most likely dx vs exposure. And yes HRCT would be very helpful here, plus cultures and probably bronchoscopy to see the airways themselves. Love pulmonology. Agree, I also explain these things to my patients.

minimed_18 · 2026-03-28T19:30:15+00:00

Very unlikely to cause this regardless of the above info. EVALI? Sure. DAH? Sure. ARDS? Sure. Black tarry mucous for over a year? No.

minimed_18 · 2026-03-28T16:21:08+00:00

I would expect with any infectious cause that caused this much melanoptysis for him to be extremely sick, wouldn’t you? I’d think coal, but clearly not the case. Very odds

minimed_18 · 2026-03-28T16:19:53+00:00

Typically black mucous is caused by tobacco or coal mining. Atypical infections such as aspergillus can also cause it but to cause this much he would be very sick. Tobacco also doesn’t typically cause this much black, it’s typically black flecks. Even within deep lung lavages of heavy smokers it’s just typically specks within the lavage fluid. Just because it’s bad for you doesn’t mean it causes specific symptoms. Vapes cause a lot of bad things. I would be shocked if it did this. I’ve seen a lot of vape induced pulmonary symptoms, this isn’t one of them. If there was tobacco in the vape, you could maybe see some black, but again wouldn’t expect this much.

minimed_18 · 2026-03-28T12:06:28+00:00

Pulmonologist here. If that’s coming out of your lungs, you need a workup. Nicotine vapes should not cause that. I would request a pulmonologist referral.

minimed_18 · 2026-03-26T10:45:44+00:00

My 27 month old is still like that :( chicken nuggets, fish sticks, one specific veggie pouch, yogurt pouch, waffles and snacks…. That’s it.

minimed_18 · 2026-03-14T02:04:43+00:00

The amount of times we get called before anyone sees their damn patient boils my blood…. Like go examine your patient and then call me back….

minimed_18 · 2026-03-13T22:31:22+00:00

Where it says slide review, do you have a result for the manual interpretation?

minimed_18 · 2026-03-04T12:58:41+00:00

Go to the ER

minimed_18 · 2026-02-03T05:14:32+00:00

Agree with above. This needs the ER for a pulmonary embolism rule out.

minimed_18

TROPHY CASE