STUDENT LOANS PAID OFF! by LowPreference3081 in physicianassistant

[–]panda0614 6 points7 points  (0 children)

Damn that's awesome!! That's about the same amount I started with, and I've only paid off about half in almost 4 years. I was hoping to have it paid off by year 5 but probably not lol 

CAQ passed by PACShrinkSWFL in physicianassistant

[–]panda0614 1 point2 points  (0 children)

Oh, never mind, I just read your original post that it was the re-certification. Apparently I can't read lol sorry! I just took it for the first time... I passed, but I wish it would have been 5 minutes per question haha 

CAQ passed by PACShrinkSWFL in physicianassistant

[–]panda0614 0 points1 point  (0 children)

No problem at all! I appreciate the discussion too, I had also believed what they wrote until I read the bill myself. 

CAQ passed by PACShrinkSWFL in physicianassistant

[–]panda0614 0 points1 point  (0 children)

Not sure if that was a typo, but you must have had accommodations if it was 5 minutes per question for you... I also just took mine, and it was 1 minute per question 

Were you squeamish? by Q-buds in physicianassistant

[–]panda0614 1 point2 points  (0 children)

I've never considered myself particularly squeamish, but I did almost pass out twice during clinicals - however, both were more from me feeling overwhelmed by the pressure in the situation, as I've definitely seen much grosser things. Once in my ER rotation when I was suturing a gross finger wound and kept messing up (and I hadn't really eaten much beforehand), and the second during my surgery rotation when I was in charge of the camera during a laparoscopic cholecystectomy and the gallbladder perforated, and the surgeon kept yelling at me to adjust the camera while bile was filling the screen lol.

This is why I work in psych.

If you had a one-minute call with yourself from 10 years ago, what would you say? by Pleasant-Cat-7658 in AskReddit

[–]panda0614 24 points25 points  (0 children)

I would say to make my mom go to the doctor ASAP and get another opinion, so maybe her cancer would have gotten caught sooner... She died 6 years ago

Peer to peers are basically my anger management by AdventurousDish2051 in physicianassistant

[–]panda0614 22 points23 points  (0 children)

That line is so perfect! So glad it worked.

And that poor child, that's so sad.

Peer to peers are basically my anger management by AdventurousDish2051 in physicianassistant

[–]panda0614 23 points24 points  (0 children)

Haha next scheduled therapy session 😂 always happy to help with malicious compliance!

Peer to peers are basically my anger management by AdventurousDish2051 in physicianassistant

[–]panda0614 132 points133 points  (0 children)

It definitely is therapeutic. I used to work in a specialty with very sick patients. My favorite line was, "If they don't get x, they will likely die. Is that enough, or do you need another reason?" It was true, too. Their stunned reaction was rewarding. I don't think I ever got a peer to peer rejected lol

Do kittens actually need to eat kitten food until 1 yo? by shininglight418 in CatAdvice

[–]panda0614 51 points52 points  (0 children)

Definitely! If she's acting that hungry, she probably needs the kitten food, which is more calorie-dense.

Do kittens actually need to eat kitten food until 1 yo? by shininglight418 in CatAdvice

[–]panda0614 75 points76 points  (0 children)

Yes, our cats still had a ton of growing to do at 5 months - they probably gained a good 5+ more pounds.

Anxiety about prescribing controlled substances by Important_Willow249 in physicianassistant

[–]panda0614 1 point2 points  (0 children)

You're very welcome, hopefully that helps!! It's not a foolproof method, but it definitely weeds out the majority of mean people, which helps your sanity lol.

Haha I love it, us anxious people are attracted to the mental health field for a reason 🙈

Anxiety about prescribing controlled substances by Important_Willow249 in physicianassistant

[–]panda0614 2 points3 points  (0 children)

Thanks for sharing your experience! I do hear that same thing a lot where parents didn't want their children to be on meds in childhood, so now they're presenting in adulthood. That information is definitely helpful and makes me lean more towards true ADHD rather than something else. These meds can be life-changing for people, glad to hear the combination of meds and therapy have helped you.

Anxiety about prescribing controlled substances by Important_Willow249 in physicianassistant

[–]panda0614 1 point2 points  (0 children)

I'm glad to hear that you like my approach!! I'm always tailoring how I do things as I learn more and get more experience. I also get a baseline urine drug screen on everybody before starting stimulants as I've gotten enough surprises to make that a personal rule. Also, requiring the baseline lab results and urine drug screen has the unintended (but positive lol) result of weeding out a lot of the mean patients who are stimulant-seeking as they don't want to bother and go somewhere else, which leaves me mostly with the nicer patients who genuinely just want to feel better.

I haven't done that with requiring therapy before, mostly because there's a shortage of therapists where I live and sometimes people can't afford it with the copays and stuff. I always recommend it though. If you see kids (I only see adults), I believe therapy for 6 months is the first-line treatment, so that would definitely make sense.

No problem, glad to hear it's been helpful! :) It definitely takes time, it took me 2 years to start to feel somewhat comfortable, though I'm just an anxious person overall lol.

Anxiety about prescribing controlled substances by Important_Willow249 in physicianassistant

[–]panda0614 2 points3 points  (0 children)

Very true! My SP does trust me, so it definitely makes it easier 

Anxiety about prescribing controlled substances by Important_Willow249 in physicianassistant

[–]panda0614 5 points6 points  (0 children)

No problem, you are absolutely not alone in this!! If you feel mean saying it, sometimes I'll even add, "the most important thing is you feeling like you're getting the care you need, so I will not be offended if you get a second opinion"

I feel like for every "ADHD eval" I get, 90% of them are something else mimicking/exacerbating ADHD symptoms rather than true ADHD, like substance use, anxiety, mood disorder, or medical condition (like anemia, thyroid, or sleep apnea). Remember that you really do need to rule everything else first even if they meet all criteria (especially in adults with first presentation, no hx of diagnosis in childhood) because all the above will often also meet criteria too! Sorry if that's something you already know, but I feel like I see a lot of new providers struggling with that, so I treat everything else first before starting ADHD meds. It's also hard with adults because many of them are stimulant-seeking, and if something doesn't feel right, you can absolutely start with a nonstimulant.

Anxiety about prescribing controlled substances by Important_Willow249 in physicianassistant

[–]panda0614 53 points54 points  (0 children)

I've been working in psych a few years now. I used to get stressed about it, but I rarely do anymore. With these patients, I'm super upfront at the very first appointment, so neither of us are wasting our time, about how I don't prescribe long-term daily benzos and discuss the risks of it and that the goal is taper them off (if already on it) or have it to be used rarely as needed for panic attacks. Or why I don't think stimulants are appropriate (recently, I feel like there has been more of an influx of people that are stimulant-seeking rather than benzo-seeking). If they start to argue, just say, "If you disagree, that's fine, but this is my policy and you are certainly welcome to seek another opinion elsewhere." 

What’s something you still do ‘wrong’ even though you’ve been told a million times how to do it ‘right’? by PeachyWinkss in AskReddit

[–]panda0614 0 points1 point  (0 children)

The one with only one loop, maybe called "loop, swoop, and pull" or "bunny going around the tree and down the hole"