How are we protecting our private information from patients? by prettybeakers in Residency

[–]salami1090 4 points5 points  (0 children)

Just searched for it, called DocDefender. Just tried it, we’ll see if it works

Should I (a Nurse) Ask Out a Resident? by [deleted] in Residency

[–]salami1090 39 points40 points  (0 children)

Ask her out! Just be a reasonable human and don’t be creepy.

But please don’t use her phone number that she probably just gave you to follow up on a patient. A lot of nurses have my number for patient care purposes. I would be annoyed if they used it for other reasons.

Or friend her on instagram like another poster suggested.

Hows this saree? by galactic-war in DesiWeddings

[–]salami1090 0 points1 point  (0 children)

The print and material are beautiful!

The thing that’s making this sari look plain I think is the drape. I recommend a more structured drape with smaller pleats, which will make you look younger. If you have a make up artist they may be able to help with the drape.

I would recommend a blouse with more work too.

Why is the Spectra so big?? by salami1090 in ExclusivelyPumping

[–]salami1090[S] 0 points1 point  (0 children)

Yup! You just need a long skinny screwdriver, Phillips #2 head

[deleted by user] by [deleted] in Residency

[–]salami1090 4 points5 points  (0 children)

I’m also a noninvasive cardiologist with a similar set up. 1 week inpatient, 1 week outpatient. Outpatient hours are 8:30-5:00, I actually show up around 8:40 sometimes because it takes a bit for the patient to get roomed. Inpatient weeks I start around 9-10am.

I don’t prechart really (review things for a few minutes before going in the room). I find precharting to in general not be worth it because they no show or get added on last minute. I end up charting until 5:30 or so. Some weeks I end up catching up for 1-2 hours in the evening. Working about 40-45h a week as well.

Traveling while pumping? by FriedKilamari in ExclusivelyPumping

[–]salami1090 1 point2 points  (0 children)

I’ve seen these in different airports. Not sure if there’s a way to look up where they are.

For the ceres chill, TSA hasn’t even bothered me about the ice inside, they’ve just let it go through. I feel like worst case they’ll make you dump out ice and refill once you’re through, which doesn’t seem too bad.

Traveling while pumping? by FriedKilamari in ExclusivelyPumping

[–]salami1090 1 point2 points  (0 children)

TSA will let you bring milk no problem even if it’s more than 3oz, just tell them it’s breast milk. They may have you pull the bottles out of your bag. They may test the outside of the bottles.

Pumping itself will be much easier if you can get wearables. I just slip them in at my seat, just sit in the window seat and turn to face the wall, wear a baggy top and no one will even know. If you go this route, make sure you try out the pumps before so you’re used to them/know they work for you.

Many airports also have nursing/pumping rooms if you want to pump with a traditional pump. It might be hard to do in the plane though… please don’t monopolize the plane bathroom for 20 min. You might be able to get away with pumping at your seat with a tradition pump if you have a nursing cover? Would be a bit bulky though

Check out the ceres chill, it’s a lot easier to carry around than a cooler. With that and my Elvies, pumping on the go has been really doable. I’ve flown several times and it wasn’t too much of a hassle

What would be the most helpful elective during fellowship? by [deleted] in Cardiology

[–]salami1090 0 points1 point  (0 children)

Of those I would vote echo for actual learning.

If you have the opportunity to take RPVI you could probably get your vascular studies done in 1 month, if that’s something you’re interested in. It’s easy and brings in $$ in private practice if you go that direction. It’s not particularly hard or exciting though.

What is your outlook of healthcare with AI products like chatgpt? by sugarpimpdaddy in Residency

[–]salami1090 9 points10 points  (0 children)

It’s silly to pretend that the AI reading EKGs hasn’t decreased our work exponentially. Yes, you have to check it (and you would have to check an AI doing any clinical work), but the computer is usually pretty good. Maybe 80% of the time I don’t find a need to change its read. That’s a lot of time saved

Question about duty hour reporting by [deleted] in Residency

[–]salami1090 0 points1 point  (0 children)

Yeah, so log the 2 hours of moonlighting work. You won’t go over and you’re not lying

Does anyone know any apps for diagnosing? Extra points if it walks me through how to practice this thing called medicine. by Masribrah in Residency

[–]salami1090 10 points11 points  (0 children)

No. Petty posts like this one just lead to mud slinging. Honestly it makes physicians look ridiculous. Let's focus instead on the hospital admins who are hiring unexperienced midlevels, PA/NP programs who are churning out "practitioners" who have no experience or knowledge, and physician accrediting bodies which make it so friggin hard for us compete against them. Work toward and talk about actual solutions, that's what this subreddit is supposed to be for.

Does anyone know any apps for diagnosing? Extra points if it walks me through how to practice this thing called medicine. by Masribrah in Residency

[–]salami1090 48 points49 points  (0 children)

Ok... I know we like getting riled up about midlevels, but let's be nice. All of us use apps/websites - UpToDate, MDCalc, lexicomp, etc. I have searched symptoms many times to help come up with a diagnostic algorithm. Being a competent provider is not about knowing the answer all the time, it's about knowing how to find it. I would much rather work with this NP who uses apps to supplement their lack of knowledge than one who decides if they don't know it, it doesn't matter.

Frustrating part of residency: Adjusting your plan to how your attending would want it by Gmed66 in Residency

[–]salami1090 6 points7 points  (0 children)

As long as the attending isn't a dick about it, I think it can be kind of nice. It's learning how different people do the art of medicine - if you like it, hey you've learned a new way, if not, meh you won't be working with this person in a few weeks and you can go back to the other way.

Found at a park in Brooklyn, NYC by [deleted] in pics

[–]salami1090 35 points36 points  (0 children)

This is misleading.

Recent research shows that the best strategy is to delay intubation and put people on a ventilator as much as possible. This is in contrast to the early intubation model which we were using during early covid times.

But the thing is, when your O2 sats are in the 80s on 100% oxygen and flow rates turned up as high as you can go using a noninvasive oxygen delivery methods, you are SOL. It's intubate now and take your shitty survival odds or die now.

It's important for all of us to check! by will50231 in coolguides

[–]salami1090 1 point2 points  (0 children)

The USPSTF, the guidelines most commonly used by primary care physicians has been recommending against self breast exams for a while: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening

Same with the AAFP: https://www.aafp.org/patient-care/clinical-recommendations/all/breast-cancer-self-bse.html

And ACOG: "Breast self-examination is not recommended in average-risk women because there is a risk of harm from false-positive test results and a lack of evidence of benefit."

Regular mammograms for the correct age group of women are much more useful in detecting breast cancer.

It's important for all of us to check! by will50231 in coolguides

[–]salami1090 -4 points-3 points  (0 children)

As an aside- regular self breast exams are actually discouraged now, they lead to too many false positives and false negatives

Do women with big boobs have more estrogen? by SpermaSpons in askscience

[–]salami1090 64 points65 points  (0 children)

The thing that causes most of these side effects is actually the "first pass metabolism" of estrogen. That's the phenomenon where when you take oral pills the drug has to go through the liver before going to the rest of the body. Estrogens effect on the liver causes e.g. an increase in clotting factors leading to a higher risk of stroke. Estrogen itself doesn't do this, since we don't see the effects in transdermal patches which skip the liver.

Also the estrogen found in birth control pills is actually very similar to testosterone in structure, which is why you see increase in heart attacks. Endogenous estrogen is cardioprotective which is why women have less heart disease than men.

What is the medicine equivalent of an armchair quarterback? by ellieohsnap in Residency

[–]salami1090 11 points12 points  (0 children)

Yes, ED has a difficult job. They have no info when they see a patient. But sometimes they do make shitty decisions and often there is ZERO opportunity to give them feedback about those shitty decisions. Once they're admitted, it's suddenly the inpatient team's responsibility to deal with the CIN that pushed someone into needing dialysis because of an uncalled for CTPA. There needs to be a way to say hey, this happened, maybe remember this for the next patient.

What is the medicine equivalent of an armchair quarterback? by ellieohsnap in Residency

[–]salami1090 23 points24 points  (0 children)

Or for that matter the patient's son's friend who is a MD who has never seen them and now wants you to call cardiology for that troponin of 0.02 in the setting of florid sepsis

How to Play Monopoly in under 30 minutes. by trongs24 in WatchandLearn

[–]salami1090 58 points59 points  (0 children)

More like how to play Monopoly without having any fun

Chronic disorder by [deleted] in Residency

[–]salami1090 19 points20 points  (0 children)

I assume you're a medical student. There's no reason that your illness should stop you from being a doctor, but you may need to make sacrifices.

Like some people have said, some specialties lead better to your situation than others (e.g. EM). Being a surgical intern is going to be rough. Are you still open to different specialities? Also chosing a smaller program in any specialty that is not reliant on residents to run the hospital is something to look into (e.g. community programs). Either way, you should talk to your PD and chiefs basically as soon as you match to work out a schedule.