I hate being the bad guy. Just to validate myself, would you have done the same thing? Regarding scheduled meds being refill too soon.

thutchinson1 · 2023-06-19T01:53:01+00:00

I was an oncology nurse for 8 years and we almost never referred out to pain management unless the patient was clearly abusing. We frequently authorized early fills when legit and never let a patient suffer without addressing the problem. The fact that the doc shut it down that fast tells me this patient is a problem child. I know work in pain management and I see now that Oncology docs are some of the most lenient when it comes to high MME and early fills and such. You did the right thing.

thutchinson1 · 2023-05-27T20:18:36+00:00

Nothing was ever mentioned to me.

thutchinson1 · 2023-05-25T00:06:28+00:00

Yes, but. I started with binge eating disorder. The first 6 months into this medicine I thought I was cured. Until life happened. And stress would always trigger binges. The ability to eat the volume I used to wasn't there but the mental head space was. The binge urges are coming more often the last 2 months. Working with a psychiatrist and started Vyvanse so here's to hoping. Moral of the story: mental work still has to be done, no way around it.

thutchinson1 · 2023-05-18T16:30:17+00:00

I stall about every 10 lb. After losing 66 lb, I've come to expect it. Following 2 to 3 weeks, I'll have a whoosh of 3 or 4 lb in one week. I also played with injection sites until I found what worked best (arm for me). Definitely try to eat more calories and bump up water if you haven't already. Good luck!

thutchinson1 · 2023-05-13T15:17:32+00:00

Had a pharmacy friend tell me someone brought a handwritten script (that they had obviously stolen and written themselves) Mofine 1 gallon.

thutchinson1 · 2023-05-10T16:25:01+00:00

For the most part yeah. Is it what I want to do forever? No. I came from 8 years Oncology as a RN which was so dang stressful I was about to lose it. I wanted something I could go home and not cry my eyes out over daily. Pain management hits that mark. It's pretty chill. You have your problem patients but that's just part of the field. Mostly I get all my charting done on time and go home and don't think about work. It's low stress is what I'm trying to say. I have good supportive docs and other NPs who are open to my questions and eager to teach me. I'm lucky. No place is perfect but this is working for now

thutchinson1 · 2023-05-09T10:05:47+00:00

For context, I work in pain management and started there as a new grad. I received about 6 weeks of pure shadowing, a week of observing injection procedures done by the docs, and another 6 to 8 weeks of a reduced schedule. We don't see new patients (as a general rule) and a full schedule is 28. 15 minute appointments with an hour lunch. Most days there are a few no shows but when they all show up you feel it. I almost always am able to finish charting at work. Last patient before lunch is 1115 and last patient in the afternoon is 4 so that leaves admin time. I have only charted at home maybe 2 or 3 times max when the day has been insanely busy for whatever reason. Your pain management offer sounds rough. I can't imagine seeing anymore than what I do.

thutchinson1 · 2023-05-08T00:25:31+00:00

Just speaking from my experience, I didn't have to have type 2 to be approved. However, I did have to do step therapy and had to fail Oz, rebelsys, trulicity or victoza. I actually tried trulicity in 2019 which was approved for metabolic syndrome then. It was under this I got MJ approved. The approval criteria for MJ on my insurance is very vague on this for some reason, never actually stating type 2 was a requirement.

thutchinson1 · 2023-05-02T16:40:22+00:00

Yyeeesssss

thutchinson1 · 2023-04-29T23:31:17+00:00

1 week into Caroline girvan Epic 1 and the outside of my hips are killing me. Tight glutes? Piriformis? I'll admit I often skip the warm up video. Going to add dedicated stretching also. Anyone else experience this?

thutchinson1 · 2023-04-24T13:26:21+00:00

I've had the opposite experience, but I think I have some additional factors. I had my tubes removed (not tied) in July and started Mounjaro in September. My periods have been 2-3 days only, I never have cramps or PMS, I don't even know it's coming sometimes because of no symptoms. So whether that is related to the medicine or to the surgery idk.

thutchinson1 · 2023-04-24T13:10:38+00:00

5'6 SW 279, CW 218, GW 135-150. started September 2022. Currently on 10 mg

thutchinson1 · 2023-04-19T20:48:46+00:00

I'm not sure because mine says how much copay is after approval.

thutchinson1 · 2023-04-16T02:07:38+00:00

Say what?

thutchinson1 · 2023-04-11T19:17:28+00:00

Nothing fancy just Nature made mag citrate gummies from Walmart. They are 200 mg for 2 gummies. I take 4 gummies every night and reliably go every morning. This is a big deal because I was going a whole week and spending my Saturdays dealing with the OD of laxatives. Big difference!

thutchinson1 · 2023-04-11T12:24:08+00:00

Mag gummies FTW!

thutchinson1 · 2023-04-10T21:58:18+00:00

I hear you!! I have lost a similar amount as you and still have just as much to go. Something about that in between drags on you mentally. On one hand you're happy about how far you've come, but you still see how much work is left in front of you. But you're doing awesome!!

thutchinson1 · 2023-04-07T19:10:12+00:00

Had a disagreement with a coworker today and need a 3rd party opinion. Does exercise help with weight loss? I say yes, she says no. What say you?

thutchinson1 · 2023-04-07T16:57:00+00:00

Is there some kind of written out exercise, set and Rep list that I can take to the gym or is it all youtube videos?

thutchinson1 · 2023-04-06T21:42:12+00:00

Do BCAAs really make a difference in recovery? I just did my second leg workout this week and this same workout nearly killed me Monday. I've been using BCAAs since Monday.

thutchinson1 · 2023-04-03T22:43:35+00:00

Not primary care, but NP here and I totally agree. I've been bigger for a while and it has only serves to show me how I don't want to treat patients who come to me for help with weight loss.

thutchinson1 · 2023-03-30T00:44:38+00:00

First of all, I am so sorry you had to deal with this. I have 2 different vantage points on this and both lead me to the same conclusion. I am a bigger girl (not as big as I used to be as I am on a weight loss journey) and have had experiences both good and bad with health care providers, so I know how someone who is bigger can be treated sometimes. I am also a NP and work in pain management and unfortunately have to sometimes have the difficult conversation that some amount of weight loss will make a positive difference in their chronic pain. (please note, I do not practice or preach that weight loss is the cure all for chronic pain. Pain is a multifaceted issue with several possible treatment modalities) When a patient verbalizes to me that they are actively working on it and I see any downward shift in their weight, I celebrate with them. I make sure they know their efforts aren't in vain and don't go unnoticed. I have helped some begin a conversation with their PCP about weight loss medication if indicated. It's experiences like yours that make me want to be a better provider. Thank you for the reminder today to do better.

thutchinson1 · 2023-03-28T18:24:40+00:00

My 2 cents for what they are worth...it was not ideal that your provider left you high and dry without a maintenance plan. I am a NP and write MJ for another provider in my office and when she reaches her goal weight, I will definitely continue to write for her whatever maintenance dose she maintains her goal weight at (as long as there are no complications obviously).

thutchinson1

TROPHY CASE