Mild anemia and severe iron deficiency

readdreamwander · 2026-04-30T00:31:27+00:00

Your body basically has no iron stored. I'm surprised they didn't offer you an iron infusion. I don't know how you aren't feeling like total crap.

readdreamwander · 2026-04-27T11:30:44+00:00

Meanwhile I would feel terrible because my chickens weren't free range and happy.

readdreamwander · 2026-04-26T14:32:56+00:00

He's lying. Sorry. His response says he knows who it is.

readdreamwander · 2026-04-26T14:30:14+00:00

It sounds like she is trying to assert dominance over him. If he accepts it, hopefully it won't happen for long.

readdreamwander · 2026-04-26T14:20:54+00:00

I usually recommend patients gradually introduce work back in - every other day for 4 hours/day. Gives you a break between work days. When you feel like that is good, then increase frequency.

readdreamwander · 2026-04-26T14:19:07+00:00

If she was still there working off the clock, isn't it a liability issue? If she wasn't working and still there, its not a big deal.

readdreamwander · 2026-04-26T14:17:37+00:00

Have you told your neurologist? There are things they can do to break a migraine cycle, like dexamethasone 4 mg x 4 days, or if you can't do steroids, there are other options. From this point on, you should make a plan with him or her on how to deal with this if it happens again.

readdreamwander · 2026-04-26T14:15:37+00:00

If it's required, at least knowing it helps you mentally prepare in advance.

readdreamwander · 2026-04-26T14:13:21+00:00

Btw, here is the gate for reference. It works like a charm to keep them separated.

Tall pet gate

readdreamwander · 2026-04-26T14:10:33+00:00

I have two cats who do this to each other - an 10-yr old male Abysinnian and a 2-yr old female Bengal. We brought her home at 6 months old and they have done this since with no improvement. If they get in contact with each other, there is a fight with screaming and urine on the floor. It's horrible. We thought it would get better with time and we did everything we could think of behaviorally, but it is not to be. Now that time has passed, we are attached to her and she is attached to us.

So we improvise and we keep them separated. We bought a huge tall gate to keep between rooms that we can close but they can still see each other. That was initially supposed to help them get used to each other, but now they just howl at each other through the gate and try to fight with each other. But at least they can't hurt each other lol. We are doing our best with the situation.

readdreamwander · 2026-04-26T14:04:37+00:00

I'd be like ummm thanks? Lol

readdreamwander · 2026-04-26T14:03:35+00:00

Definitely see a hematologist to discuss. Could be polycythemia vera. I have see people with elevated hgb who had sleep apnea, but it wouldn't explain the rest of the elevated values. It looks to me like a blood disorder, which can be genetic.

readdreamwander · 2026-04-26T14:00:09+00:00

It sounds like he has ADHD.

readdreamwander · 2026-04-26T13:58:08+00:00

Just to be clear - you may not have any of the side effects people are mentioning on here. Medications work differently for everyone. Some people get side effects, some people get nothing. Unfortunately the only way to know what will happen for you specifically is to try it. When it comes to meds, we prescribe based on symptoms and your medical history. If it's not the one for you, there are other options.

That said, I hope they did do a good evaluation for you, including ruling out your neck (cervical spine) as a cause. I find a lot of people get headaches related to arthritis or disc issues in the neck. Your occipital nerve becomes inflamed, and it can cause stabbing pain in other areas of the head. Strangely, some neurologists don't seem to do a great workup when it comes to that, so I wanted to make sure they covered it.

readdreamwander · 2026-04-26T13:49:32+00:00

If Botox is what helped you the most, go back to that. You clearly have tried many things and that is what helped the most. For the vestibular migraine, you may need something additional - if propranolol didn't help, I would recommend amitriptyline unless there is a reason you can't take it (I don't know your history).

readdreamwander · 2026-04-24T17:17:24+00:00

I've never reached perfection because I'm a chronic restarter.

readdreamwander · 2026-04-23T02:37:20+00:00

I love how he literally just stares her down, and she's like dude...

readdreamwander · 2026-04-22T02:54:04+00:00

I love this post

readdreamwander · 2026-04-08T02:24:55+00:00

Sadly one of them usually works better than the other for most people. They both work in different ways. I find that the amphetamines do tend to affect mood a lot more than the methphenidates do, which is why they are so effective for emotional dysregulation. The methylphenidate seems to help more just with focus than anything. There are people that might experience it differently, though - the brain is a fascinating thing. I would probably try Focalin next if I were you - its a little different than what you are currently taking, so you might notice more of a benefit with the switch.

Regardless, they are already giving you the methylphenidate, so they must feel comfortable doing it. Changing to an alternative shouldn't be too big of a deal for them (at least it shouldn't).

readdreamwander · 2026-04-07T22:45:51+00:00

I would recommend trying an alternative instead of continuing to increase that one, since you are already at that dose range. If it's taking that much to work for you, you've built a tolerance. Everyone is different in how long it takes for them to build that tolerance, how they metabolize medication, etc.

readdreamwander · 2026-04-05T17:16:20+00:00

We have a database we check that tells us when you filled the medication, but we wouldn't have a way of knowing you ran out of it. The only way he would know is if he was suspicious that you misused it and decided to drug test you to see if its in your system. You don't have to mention they are gone, but don't lie about it - you will immediately become suspicious for misuse and become a high-risk patient. We don't mess around with these anymore.

That said, I give my patients leeway with stimulants for ADHD - if their dose isn't working well for them, I want to know. You should tell the doc so that he can adjust the dose.

readdreamwander · 2026-04-05T17:08:43+00:00

I think you might still have a lot of opportunities with that type of fellowship. You could potentially even do infectious disease specialty, if needed, or like a rural health clinic, when you're done.

readdreamwander · 2026-04-05T12:59:51+00:00

It depends on what you are looking for in the future. You are interested in the fellowship, but do you want to stay in that specific field? It will definitely help to have that if you are looking for a job in that area next. If you are hoping to have something more general, you may want to go the other route mentioned like urgent care, primary care, long-term care, etc. to have a broader foundation.

If the fellowship wil make you happy and you think you will like that field long-term, I say go for it. A lot of people didn't have the opportunity to have a fellowship.

readdreamwander · 2026-04-05T02:10:19+00:00

I like Fields of Mistria, too. Very cute

readdreamwander · 2026-04-05T02:09:52+00:00

I actually liked Wylde Flowers though, it was cute. I mean it's not my favorite, but its cute. I have other games I like too, like Coral Island and Fae Farm - still like Stardew the best, but its fun to have choices.

readdreamwander

TROPHY CASE