medgremlin

joined 8 months ago
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[–] [email protected] 5 points 1 day ago* (last edited 1 day ago)

The issue comes from the fact that if there's any amount of implantation and the very earliest stages of development, a pregnancy test will come back positive and there are many diagnostic tests (most imaging modalities) and many procedures (such as non-obstetrical emergency surgeries) that will get delayed or sometimes even denied because of the positive pregnancy test. Every AFAB that comes through an ER that might need imaging gets a point-of-care pregnancy test that has to come back negative for something like a CT scan unless it is a very dire situation because of the radiation risk to a developing embryo.

Obstetrical procedures like abortions are not the only ones that are gate-kept for AFAB patients because of the policies surrounding risks to developing embryos or fetuses.

Edit to add: The studies do say that the estimated incidence of clinically unrecognized pregnancies is approximately 20%, but given the myriad risk factors that can feed into that outcome, things like exposures, stresses, SES, and access to medical care may increase that incidence rate in some populations.

[–] [email protected] 3 points 1 day ago (2 children)

I was referring to the many instances in which the blastocyst does implant, but fails to grow past the initial stages of development. Progression to the point of differentiation of tissues is the hurdle that many fertilized ova fail to clear. Failure of implantation is still important to discuss in the political context given that there are so many people with an absolute absence of biology education that think that life begins at fertilization.

[–] [email protected] 6 points 1 day ago

They want to go back to the days where life expectancy for women is to the "ripe old-age of died in childbirth".

[–] [email protected] 23 points 1 day ago (6 children)

The proportion of pregnancies that end in miscarriage is MUCH higher than that. Many "pregnancies" (read: fertilized ova) don't implant in the uterus or implant and fail to progress which ends up looking like a heavy period that's a little late. Judging the start of "life" as fertilization is absolutely inane because of how many fertilized ova just don't make it past 16 cells or so.

[–] [email protected] 9 points 3 days ago

I was about to comment a similar sentiment. I didn't realize I stopped existing or had my gender identity reassigned because I'm on lemmy instead of other social media.

[–] [email protected] 2 points 4 days ago

I didn't originally set out to go to a DO school, but I do like the approach that they teach us which is to treat the patient as a whole person. Someone's psychological health can be suffering because of poor physical health and visa versa, so it's important to work on both, and to make sure that the treatments being discussed are actually feasible and reasonable for them to try to adhere to. (i.e. telling someone to "just lose weight" without working with them on strategies on how to do so in a safe and manageable way is just plain stupid.)

[–] [email protected] 2 points 4 days ago (2 children)

Agreed. It's always more complicated than "just psychological". There can be a psychological element to it because things like emotional stress can have downstream effects by way of over-activation of the sympathetic nervous system, but it's not a be-all-end-all explanation. The mind is powerful and can exert influence over the rest of the body, but that just means that you have to treat the psychological portion as well as the somatic portion.

[–] [email protected] 22 points 5 days ago

At this point, Israel is a rogue terrorist state that needs to be cut off from all material and financial support until they agree to permanent ceasefires and handing Netanyahu and his cabinet over to the ICC.

[–] [email protected] 7 points 5 days ago

He was banned from trying to join any branch of the military because he did so poorly on the ASVAB (and probably also failed a psych eval). While many police departments are deeply corrupt, I don't think any of them want the bad press that would come with hiring him. Maybe he can get hired as a deputy in a sheriff's department run by someone like Arpaio.

[–] [email protected] 14 points 5 days ago* (last edited 5 days ago)

"Assault" is shouting and threatening, "battery" is actually making contact. It sounds like she got the pepper spray out in time to prevent him from touching her, which is a very good thing.

[–] [email protected] 16 points 5 days ago* (last edited 5 days ago) (2 children)

Usually the situation they put themselves in is taking a job as a cop and refusing to deescalate any situation.

[–] [email protected] 2 points 5 days ago (4 children)

I'm pretty sure I've gotten a couple board questions wrong because I leave stuff like conversion disorder/functional neurological disorder so far down my differential that it's basically in the trash anyways. I see it as a diagnosis of extreme exclusion.

The immune mediation would explain why AIDS medications might work though, particularly if it's one of the viral synthesis inhibitors.

 

I like to go through and take a couple of these tests every now and then to kind of check up on myself to make sure I'm not developing biases that will negatively impact my ability to care for my patients. I think it's probably a good idea to at least get a baseline for yourself so you know when you're most likely going to need to self-monitor what you say and do more closely.

 

I'm currently a medical student and a licensed EMT with a chunk of professional experience in medicine as well as having multiple chronic illnesses, a couple of which are very stigmatized. I've kind of settled into conducting my appointments like I'm presenting a patient to an attending physician. I still use I/me/my/mine and describe things from my perspective, but it's still a rather....professional(?) discussion. I feel like it helps me approach the conversation in a productive way, and my physicians seem pretty receptive to my suggestions for treatment and testing...but it also feels like I'm dehumanizing myself a bit.

The biggest issue I've had tends to be with nurses/NPs/admin/etc when I call and say "hey, I'm having these weird symptoms and I think this is the diagnosis, can you get me in to see the physician?" and they sort of short-circuit almost because they seem to be in the habit of exerting their own judgement about a situation.

I recently had a nurse try to punt me back to my primary care physician because the specialist was out of the office and she wouldn't escalate to the physician on-call because she didn't understand that I had already talked to my primary care physician and she said she wasn't equipped to deal with it. (This was an issue that has the potential to be life-threatening in a matter of days that, fortunately, I knew how to kinda sorta manage on my own for a little bit.)

 

Personally, I try to present myself as excited for the training with some degree of competence without trying to pretend like I already know....anything? I feel like I have some trouble striking the perfect balance between competent and receptive, or maybe it's a balance between confidence and humility.

I think erring on the side of humility and receptiveness is a better bet if you're not sure where the balance is, but I'd like to hear from other folks' experiences and perspectives.

(I'd also be grateful for perspectives from folks who have been preceptors or instructors!)

6
submitted 2 weeks ago* (last edited 2 weeks ago) by [email protected] to c/[email protected]
 

I'm currently in my Family Med clinical rotation, and our professor has us working on social determinants of health stuff for the didactic/academic portion. To that end, she sent us some resources and then I dug up a bunch more, so I wanted to share links to the resources I found in case anyone finds them useful in their practice for helping patients with SDOH needs.

Unfortunately, these are all going to be American resources, but hopefully they'll be helpful to someone.

If there are any other resources you know about, please share them in the comments! This stuff is so important for healthcare access, but they can be really hard to track down sometimes.

 

Post here with your title/role/qualifications and whatnot if you want to. If you want to post a region or field to look for folks in your area to network a bit, this is the place to do it!

Be respectful of people's privacy and do not dig for details. Put a note in the top of your comment if you are open to messages and/or questions.

 

(At the moment, this is likely to be America-centric for system questions unless/until we get more international representation.)

Please post queries here if you are looking for advice on what kind of specialist to seek out for medical problems. Keep descriptions of the medical concern in question brief, and limit discussion of personal details.

THIS IS NOT A SUBSTITUTE FOR PROFESSIONAL PHYSICIAN/PATIENT RELATIONSHIPS. THIS IS EXCLUSIVELY FOR HELP NAVIGATING THE MEDICAL SYSTEM.

296
Walz for VP (midwest.social)
 

cross-posted from: https://midwest.social/post/15388609

Democratic presidential nominee Kamala Harris has picked Minnesota Gov. Tim Walz to be her running mate, wagering that a former red-district congressman with a progressive streak can help her win over working-class voters in battleground states needed to beat Donald Trump in November.

“The entire country is about to see why their friends from Minnesota can’t stop bragging about Governor Walz,” Minnesota DFL Party Chair Ken Martin said in a statement. “By picking a servant leader born and raised in a small town who has dedicated his career to protecting freedoms and lifting up working families, Vice President Harris has chosen the perfect foil for [Trump running mate] JD Vance and his politics of resentment.”

 

Democratic presidential nominee Kamala Harris has picked Minnesota Gov. Tim Walz to be her running mate, wagering that a former red-district congressman with a progressive streak can help her win over working-class voters in battleground states needed to beat Donald Trump in November.

“The entire country is about to see why their friends from Minnesota can’t stop bragging about Governor Walz,” Minnesota DFL Party Chair Ken Martin said in a statement. “By picking a servant leader born and raised in a small town who has dedicated his career to protecting freedoms and lifting up working families, Vice President Harris has chosen the perfect foil for [Trump running mate] JD Vance and his politics of resentment.”

 

A friend of mine is helping me with setting up a Linux-based homebrew security system set up. He's currently using Wyze cameras, but they are faulty and have ads on them, so I'd like to find something more open-source/closed system that I can control completely. Any recommendations or pointers in the right direction would be great.

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