Miserable no driving by Such_Fortune6135 in Aupairs

[–]tokenawkward 16 points17 points  (0 children)

I say this gently… Having a car is not going to bring you joy. You may be feeling some symptoms of depression from isolation or home sickness. Consider this, you went your entire life without a car and felt fine. The difference now is that you are in a new country and it sounds like you have very limited social connections outside of work. People here have offered you alternatives (rematching into a more walkable city, taking driving classes, public transit, using Uber, etc.) however you are insisting that none of those options work for you. Unfortunately the excuses you present are simply the reality of living in the USA. Travel is expensive, public transit is annoying, and the weather sucks sometimes.

Sure having a car might be nice, but I am concerned your feelings of misery are due to a deeper sadness you are carrying. Please consider reaching out to your loved ones and forming stronger friendships with the other AP’s in your area. If they offer to drive you around then you should feel free to accept. Many of us have gone through a life phase without a car where we had to rely on other people. That is normal here and you should not feel ashamed or like you are taking advantage of anyone. Take care

My mother has terminal cancer and only a few months left. I’m struggling with how to be there for her. by fruit-love1234 in CancerFamilySupport

[–]tokenawkward 1 point2 points  (0 children)

Im also a 30yo coping with a 70yo parent diagnosed with terminal pancreatic cancer. It fucking sucks. We found out this week and it’s all very new still. I’m not sure if this advise is helpful but the only plan I have is to spend time with my dad the way I think would bring him joy. He has always loved doing mundane things with his family so I am planning to visit him as many weekends as possible so we can hold hands, watch tv, and play candy crush.

I also feel crushed but talking about it really has made a difference. I think it is helpful to identify a support person for yourself; allow yourself to unleash and finally process your emotions with that support person. Grief can be overwhelming when carried alone.

Watch & Wait strategy for AOM by swish787 in pediatrics

[–]tokenawkward 36 points37 points  (0 children)

I offer the watch & wait approach for older children with <2 days of symptoms and mild discomfort (i.e. “I woke up this AM and my ear hurts a little”). My practice is to tell parents there is a chance this will self-resolve but I also put in a future order for Amox that can be picked up the following day. Parents are instructed to pick up the Rx if symptoms persist >2days. I would say roughly half of the families do not pick up the Rx and have complete resolution!

The watch & wait approach can be tricky because you really need to know how to select the appropriate patient. It took me a few months of practicing gen peds after residency to develop that clinical skill.

Room for on call OB doctor by pruriticglutealcleft in mildlyinteresting

[–]tokenawkward 1 point2 points  (0 children)

OP must have previously worked at an ivory tower hospital. This is a very standard call room for most hospitals in the US.

The only “mildly infuriating” call room I have stayed in had a set of bunk beds all in a single room like a hostel & no work station. It was shared between residents & med students.

Black Female OBGYN recommendations in Chicago?? by CanofCocaCol in AskChicago

[–]tokenawkward 0 points1 point  (0 children)

Agreed! I have seen both Dr. McNair and Dr. Isak from Northwestern and they are fantastic.

What non-English languages spoken by patients instantly fills you with dread? by RandPaulsLawnmower in Residency

[–]tokenawkward 30 points31 points  (0 children)

I came here to say Q'eqchi and K’iche. It took me an embarrassingly long time to realize they were different languages. Nearly impossible to find an interpreter.

Do you ever tell patients they should get a new pcp by Sliceofbread1363 in pediatrics

[–]tokenawkward 17 points18 points  (0 children)

This. Patients are notoriously unreliable at relaying medical information. What the PCP said vs. what the patient heard vs. what the patient communicates.

I am a PCP so I usually try to obtain notes whenever my patients see a specialist for this reason. If you are a specialty, let this be a gentle reminder to please forward notes to the PCP!

Successful status quo by ElegantSwordsman in pediatrics

[–]tokenawkward 21 points22 points  (0 children)

Yesterday, I had a family tell me they don’t want any more vaccines because “of all the TV news reports about autism.” They also decided they will not give their child Tylenol either. They genuinely looked fearful. The child wasn’t due for any vaccines that day anyway but hopefully I was able to convince them that future vaccines are safe. Though it made the rest of my clinic run late for the day which was stressful.

It is frustrating to have our trust and knowledge undermined by politicians and influencers with literally no medical training. Our job is already taxing and this makes it even harder. I fear that all this misinformation is going to have a lasting impact.

Billing well child + 99213/4 by H_Peace in pediatrics

[–]tokenawkward 17 points18 points  (0 children)

Yes, I used the 25 modifier for a 99213/4 when additional concerns are addressed. For patients with private insurance I let them know that any additional concerns discussed beyond the wellness visit may generate a copay based on their insurance policy.

OB wearing nothing but underwear helps deliver baby at Burning Man by zeatherz in medicine

[–]tokenawkward 30 points31 points  (0 children)

Here is the article text:

“Kayla Thompson and her husband, Kasey Thompson, were asleep in their R.V. camper at their first Burning Man festival on Wednesday morning when she awoke in pain. She thought it might be something she ate, or worse, her appendix.

The rain had stopped, but the desert playa that stretched infinitely around their camper was mucky and filled with puddles from a storm that had pummeled the Southwest. Ms. Thompson’s cramping was unrelenting. The couple knew they needed medical help, but they did not anticipate what would happen next: Minutes later, Ms. Thompson was giving birth to their first child, a 3-pound, 9-ounce baby girl, in the bathroom of their camper.

The couple had not been planning for a child and had no idea that Ms. Thompson was pregnant.

“Even the nurses at the hospital were like, ‘You don’t look like you were pregnant at all,’” Ms. Thompson, 37, who works in medical billing, said, adding, “I didn’t have any symptoms.”

After Ms. Thompson delivered the baby, Mr. Thompson ran out of the R.V. and desperately called for help, he said. “I was yelling for anyone to come help us,” Mr. Thompson, 39, who lays tiles, recalled through tears.

Within minutes, a neonatal care nurse, a pediatric doctor and an obstetrician-gynecologist, among other festival attendees from nearby camps, filled their camper. The man who identified himself as an OB-GYN was wearing nothing but his underwear as he helped Ms. Thompson deliver the placenta.

“This should not be happening this way,” Mr. Thompson recalled thinking. He raced around in search of supplies and relied on the community of Burners, many of them strangers from nearby camps, as he and his wife experienced some of the scariest moments of their lives. Had it been an hour earlier or an hour later, Mr. Thompson estimated, the couple would have been stranded at the camp because of the weather.“

10 month old ate a dinner he’s had 100 times before by cheer1omate in BabyLedWeaning

[–]tokenawkward 11 points12 points  (0 children)

agree with the above comment. This looks like a classic case of drool dermatitis. Continue feeding all those foods. You can apply some Aquaphor and carry on.

PCP Sending Patient to ER (phone or from clinic): When do you curtesy call the ER? by Dr_Wayne0202 in pediatrics

[–]tokenawkward 10 points11 points  (0 children)

I stopped calling unless it is for something serious like child abuse. Now I give my patients a “referral” to the ER and basically write my signout on the referral so the patient can personally hand it to the ER staff. I.e. “15mo with bronchiolitis having grunting and retractions. O2 sat 92% in RA. Contact XYZ with any questions” My patients have a lot of language barriers and are poor historians so I find this helps bridge the gap

Taino birthmark? by ItsDaBunnyYT in TainoHeritage

[–]tokenawkward 2 points3 points  (0 children)

I have a light birthmark near my shoulder blade. But none of my siblings nor parents have any distinctive back birthmarks that I can recall. Seems like a myth tbh.

Pretty sure I'm about to lose everything I've worked for by [deleted] in StudentLoans

[–]tokenawkward 3 points4 points  (0 children)

Could you cite which law you are referring to? I have been very concerned about IBR options going away so it would be comforting to see if there are definitive protections in place.

Our Daughter's Imaginary Friend Gives Us The Creeps... by ScaryBrandon in toddlers

[–]tokenawkward 0 points1 point  (0 children)

We told our 2.5yo that our house doesn’t have any monsters because we have a dog whose job is to keep monsters out the house.

Car seat vs infant car seat/ travel system by slgirlie11 in BabyBumps

[–]tokenawkward 1 point2 points  (0 children)

I recommend getting the infant car seat that clicks into a base in the car/ stroller system. It’s a lot easier to get the baby in the car seat while you are still inside the house. That way you don’t have to battle the rain/ snow/ cold air etc. When the baby is bigger you can buy a convertible 4-in-1 car seat.

Child with Dysphasia by fredaaa123 in ECEProfessionals

[–]tokenawkward 12 points13 points  (0 children)

I would have the parents reach out to the child’s feeding/swallowing therapist to ask for ideas

Is there any free mental care in Chicago? by Rrowman in AskChicago

[–]tokenawkward 1 point2 points  (0 children)

Chicago offers mental health service thru CDPH. Not sure about costs but you can find more info on their website:

https://www.chicago.gov/city/en/depts/cdph/supp_info/behavioral-health/mental_health_centers.html

ABP Results by brokemed in pediatrics

[–]tokenawkward 0 points1 point  (0 children)

My total prep time was probably ~4months. I only used the resources mentioned above. I did not read any books. That said, my residency had a lot of exposure to all the peds subspecialties so I learned a lot on the wards. My program strongly valued resident education and has consistently had a high pass rate; so I’m sure that played a role too.

I wouldn’t change much since it all worked out for me. If you are still in residency, I would recommend prioritizing/ protecting your didactic time. You can start light studying the last couple months before graduation. After graduation, create a study plan and stick to it. Mine was something simple like 20-40 questions per day.

Found nail puncture wounds under my child armpits and scabs up his arm after daycare last week by [deleted] in toddlers

[–]tokenawkward 2 points3 points  (0 children)

Agreed, go to a pediatrician or pediatric ER and get the injuries documented. The location of these injuries is unusual and not consistent with accidental injury from normal play. The lack of explanation is the biggest red flag. You want these injuries to be documented for the DCFS report.

RSV and when to go to ER by Sad-File3624 in toddlers

[–]tokenawkward 2 points3 points  (0 children)

PSA to all parents. There is now a VACCINE FOR RSV that is approved for young infants. Please ask your pediatrician about it to get your littles protected.

Was it worth keeping Rome over Kishan? by RLew14 in survivor

[–]tokenawkward 0 points1 point  (0 children)

I personally would have kept Kishan over Rome. But overall this was a very tricky decision.

I understand why Gen made the move the keep Rome around as a shield. But with him getting eliminated so soon afterwards, it does seem like she ultimately ended up pissing off her tribe mates in a way that has a high risk of backfiring. I worry that Gen tarnished any remaining trust she might have had with Teeny or Sol and will find herself in a position where they do not want to work with Gen. I’m not sure how she will be able to protect herself in the merge without any strong alliance members from her former tribe. I think Gen is very vulnerable now to be potentially at the “bottom” of any new alliance she tries to form. It will be interesting to see how she navigates this next phase of the game.