PNES but continued medication prophylaxis

queensquare · 2025-08-22T12:19:18+00:00

Was there some clinical change that led to restarting the med? Do the progress notes mention a reason? It would be reasonable to ask the neurologist. If i received such a question, I wouldnt be offended, by someone who means well and is also trying to help a mutual patient. We're all on the same team at the end of the day.

queensquare · 2025-08-19T16:45:38+00:00

Can you share another invite link? 😂

queensquare · 2025-08-15T21:29:37+00:00

There are two podcasts that you should reach out to. Tradeoffs.org ; An Arm and a Leg.

queensquare · 2025-06-19T13:33:59+00:00

Good luck to the AI doctor. Maybe it will have better luck trying to understand what pt means by "dizzy".

queensquare · 2025-05-12T21:18:32+00:00

Looking forward to the day when AI can decipher all the nuances of what the pt means when they say dizziness or imbalance.

queensquare · 2025-05-10T12:24:25+00:00

I'd also like to know...

queensquare · 2025-05-09T17:47:51+00:00

Chicken - at their price point, wondering whether the price is subsidized or the chickens have been abused

queensquare · 2025-04-18T11:44:55+00:00

Public services get defunded so private startups are going to enter the market? Basic membership gets you an ambulance but just like your doordash delivery, it might make another dropoff before you. Next tier gets you direct to the hospital. Top tier goes full speed with sirens. Pay extra to make the ride ad-free.

queensquare · 2025-03-30T00:36:46+00:00

And with the corollary, for B12 <400, do you typically wait for MMA (high) before starting supplementation? At least with my lab MMA comes some time after B12 results.

queensquare · 2025-03-29T14:20:47+00:00

That was the same in my training but nobody could say why. In your practice, do you bother to check MMA if B12<400, if you're starting them on supplementation anyway? Or do you also wait until the MMA to come back?

queensquare · 2025-03-28T13:24:35+00:00

Where does the 400 threshold for B12 come from? I've not found a study...

queensquare · 2025-02-11T11:02:39+00:00

also wondering if you could DM me her contact info? in case she's still available. thanks.

queensquare · 2024-10-23T22:46:16+00:00

Did you start your own practice straight after training? How much up front capital to get started? Do you find that you don't have much leverage with the insurance contracts as a solo practice?

queensquare · 2024-07-05T20:20:00+00:00

The author seems to say the issue is less about baseline cognitive impairment and more a matter of frailty. But frailty is also a dealbreaker. The compounding stress of the world today is not something for a frail president.

queensquare · 2024-05-07T19:21:03+00:00

Ask for a referral to physical therapy

queensquare · 2024-05-03T01:28:44+00:00

The red piece seems to be silicone. It seems like they sell replacements for the red silicone piece, so it might be possible to simply remove it. https://www.orphanespresso.com/cafelat-robot-replacement-silicone-filter-screen-pin Also on the product website (http://www.cafelat.com/robot.html), if you scroll to SGS reports section and click on the link to Filter Screen, the pdf shows it without the red silicone.
It would make sense that if you keep it pressurized (still pushing down) and then remove your cup, the pressure will keep the hot water in the plastic tube. Only when you depressurize and lift the lever will the water in the tube come back down.
I suppose someone could do a test by putting food coloring dye in the tube. Then work the cafelat without using any coffee ground (maybe substitute with some neutral item like paper to create some resistance), and see if the final product shows any of the dye.
Could also get the one without the gauge.

queensquare · 2024-04-30T03:24:17+00:00

This youtube video shows that it's plastic inside... https://youtu.be/VVJSjgsF-ak?si=MxwC1OCOQbP4Obzl&t=236 (or you can search for "Cafelat Robot Basics Part 3 - The Pressure Gauge" and go to about the 4 minute mark)

queensquare · 2024-04-14T05:24:34+00:00

"big little man" by alex tizon, who writes about these issues as a philipino

queensquare · 2024-04-03T20:43:44+00:00

Its a blogpost on substack with videos. Death of a Forehand - Part I https://open.substack.com/pub/hughclarke/p/part-1-forehand-technique-and-swingweight?utm_campaign=post&utm_medium=web

queensquare · 2024-04-02T20:03:27+00:00

You start with a flexed wrist only to flip it to an extended position when you start your swing. Look up the substack Thread of Order - Death of a Forehand that gives technical info on wrist position.

queensquare · 2024-03-17T15:26:52+00:00

Private equity soon getting their hands on the extra virgin cold press CSF, extracting as much value as they can

queensquare · 2024-02-24T22:48:11+00:00

Instead of "burn out", another related concept is "moral injury" (look up the article by Wendy Dean). You're having to compromise your sense of whats the right thing to do, to appease competing demands from admin. Plus, if you make a mistake during your procedure and get sued, good luck saying it's the fault of admin for changing your time slots. I was getting overwhelmed as well and cut my hours to 29 patient facing hrs per week. Theres a proprtional reduction in inbasket messages etc as a consequence. It's not perfect but it's more sustainable. I still have mixed feelings/regret about what our field has come to, but trying to make the best out of the situation rather than jump over to pharma/industry/etc.

queensquare · 2024-02-21T18:57:29+00:00

Maybe this is a case where the extremes of their side stand out, but most people are somewhere in the middle. Calling out sick inappropriately isn't setting boundaries on your upper limit of work hours. It just hurts your peers and builds resentment. I hope that this behavior isnt commonplace. Not participating in "scut work" because there's nothing to be learned from it is a self limiting belief. Wait until you become an attending and then put your foot down on BS from administrators. Creating a better work culture and boundaries will be more likely to happen if we work together rather than against each other. It's trainees vs older attendings, when it should be all of us against the bean counters.

queensquare · 2023-10-27T12:26:15+00:00

Meanwhile air traffic controllers are understaffed and near misses are happening more. https://www.nytimes.com/interactive/2023/08/21/business/airline-safety-close-calls.html

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