medgremlin @ medgremlin @midwest.social

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497

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2 yr. ago

Then support your local trap/spay/neuter charities. This is a miserable and painful way for them to die and likely wouldn't kill enough of them to get the effect you're hoping for. All you're wishing for here is needless suffering.

I have never heard of that association.

That's the only time I think it's acceptable. Ambulances are kind of a venn diagram of healthcare and couriers, so the 2 snakes on the star of life makes sense.

The medical symbol of the staff with the snake is only supposed to have 1 (one) snake on it. A staff with 1 snake is the Rod of Asclepius (the son of Apollo and Greek demigod of medicine), a staff with 2 snakes is a Caduceus which is carried by Hermes as a messenger or herald.

Physicians get 1 snake. Couriers and heralds get 2 snakes. Any medical professional or organization that uses 2 snakes is wrong and needs to go study the humanities and classics for a bit.

Yeah, caffeine is a good vasoconstrictor, so it can help with headaches that are not from something like high blood pressure. Paracetamol/acetaminophen is really good for headaches on its own because it gets into the brain better.

I was following along with some of your other comments and whatnot, but this diatribe tells me a lot about your intentions behind this post.

I have ADHD, and I'm a medical student. I suppose in your mind that makes me one of the "dumbest motherfuckers" in training, but I will speak from the education and authority that I do have. There are many health conditions and comorbidities that can make stimulants a bigger risk than they're worth. Personally, I have idiopathic sinus tachycardia, so my psychiatrist had me get a consultation with Cardiology before she would prescribe a stimulant because one of the major risks of stimulant medications is Sudden Cardiac Death Syndrome (which is exactly what it sounds like) and if you have a high heart rate or other cardiac or electrophysiological abnormalities, it drastically increases your risk.

I get that getting by without medication is extremely difficult for some people. I had to do my first semester of medical school on hard mode while I got my official diagnosis and medical clearance for treatment sorted out. Healthcare access, particularly mental healthcare access in America (and pretty much everywhere else for mental health) is criminally abysmal, but that is not an excuse to encourage people to ignore medical advice and consensus regarding medication safety.

(And as a side note: Surgeons are really good....at anatomy. Most of the surgeons I have worked with would really prefer it if the primary care/family med/internal med/literally-anyone-else doctors did the pre- and post-op medication management. Anesthesiologists are the ones that are intimately acquainted with pharmacology when considering physicians in the OR)

Alternating the paracetamol and ibuprofen on a schedule is the best recommendation I can give. Severe pain, especially post-operative pain, is best managed by taking the pain meds before the pain sets in. The ibuprofen is also an NSAID and the swelling and inflammation are big contributors to pain.

The schedule that I always recommend is:

• 0800: 650-1000mg paracetamol (acetaminophen)
• 1200: 600-800mg ibuprofen
• 1600: 650-1000mg paracetamol (acetaminophen)
• 2000: 600-800mg ibuprofen
• (and in the first day or two after surgery, set alarms to wake up and take pain meds at 0000 and 0400 on the same pattern if the pain is really bad.)

This pattern keeps you covered on pain control, and you can shorten the intervals to every 3 hours if this isn't enough without exceeding daily dose limits on either medication. If you are an American reading this and you're also taking something like Norco, make sure to account for the acetaminophen/tylenol/paracetamol that's in those because exceeding the recommended dose on that one is bad news for your liver.

Like some other folks have said, warm saline (salt water) rinses and soft or liquid foods are going to help as well.

I'm repeating my reply to someone else in the thread so hopefully more people can see it:

I looked it up and read through the NIH paper that did a review of available information about it. It’s essentially a recreational drug that can be formed in your body when you take methylphenidate and alcohol at the same time.

I will put out this caution though: there were a lot of reports of bad trips, worsened focus/cognition, dangerous side effects like increased heart rate and body temperature, and there was a very high rate of addictive responses. So it may sound like fun, but you’re running the risk of causing yourself a lot of problems and using Ethylphenidate (or methylphenidate plus alcohol) may make your regular ADHD meds less effective and lead into addiction problems.

TL;DR: This is a dangerous, bad idea and as a medical student with a decent understanding of pharmacology, I do NOT recommend doing this.

I looked it up and read through the NIH paper that did a review of available information about it. It's essentially a recreational drug that can be formed in your body when you take methylphenidate and alcohol at the same time.

I will put out this caution though: there were a lot of reports of bad trips, worsened focus/cognition, dangerous side effects like increased heart rate and body temperature, and there was a very high rate of addictive responses. So it may sound like fun, but you're running the risk of causing yourself a lot of problems and using Ethylphenidate (or methylphenidate plus alcohol) may make your regular ADHD meds less effective and lead into addiction problems.

As a woman and a DO medical student, I have been pushing back on this stuff when I see it and have been challenging my classmates and professors if they are being assholes about anything.

We weren't graded on the quality of our dissections, but the exams were based on how good the dissection was. We would have a set of assigned anatomical structures to expose and/or dissect in a given unit, and then the practical exam used our dissections. They would stick a pin in something and you had to write in the name of the structure, what nerve/nerve root innervated that structure, what was it's blood supply, or what structures should be above or below it, etc. The year before mine got absolutely screwed on one exam because almost no one finished all the assigned dissections, so the professor just stuck a pin on the outside of the cadaver with one of the questions above.

Personally, I was obsessively meticulous about my dissections and when my tankmates (other students assigned to the same cadaver) messed something up, I would get very frustrated with them. I would come in on weekends to carefully expose and clean individual arteries and nerves for hours at a time. The main anatomy professor kept asking me what kind of surgeon I wanted to be, but I'm a horrid little gremlin that likes night shift and hanging out in hospital basements, so I want to go into emergency medicine.

She did get Nobel prizes in Physics and Chemistry, so you're both right!

It's not dirt as much as it's surprise pocket sand/glitter that sticks to absolutely everything and is impossible to get rid of.

Robert Evans just did a 4 part series on RFK Jr. and it is fascinating. Links below (on spotify because that's what I've got, sorry)

Part 1

Part 2

Part 3

Part 4

I highly recommend the Behind the Bastards podcast overall. It's a great way to get your heart rate and blood pressure up to really enhance your cardio workouts or stay awake on long road trips. You will be intensely angry at everything, but it helps. :)

Well, time to Godwin's Law this discussion I guess.

What you're suggesting is an expectation for physicians to do something akin to actively defying the Nazi regime to hide/evacuate/personally protect vulnerable people who the Nazis are trying to round up. The people in Nazi Germany who put their lives and livelihoods on the line to help shield people from the concentration camps are unequivocally heroes in every sense of the word.

It is unreasonable to expect, much less demand true heroism from people who are trying to live their lives. Right now, the penalties for performing an illegal abortion in Texas are loss of your medical license and a minimum of 5 years' imprisonment, and maximum of 99 years' imprisonment, as well as a $100,000 fine per instance. (They are very generous though, in that if the fetus miraculously survives, it's only a second degree felony that carries a mandatory sentence of 2 to 20 years).

You are effectively insisting that physicians put in this position must put their entire profession, career, livelihood, and potentially even their life on the line in the hopes that the politically selected prosecutor elects to not pursue charges. That's a hell of a gamble without even beginning to consider the impact of the loss of a physician would have on their community.

This is a political problem with a political solution, but despite my own intentions and moral convictions, I would never presume to insist that another physician puts everything on the line to stand up to the modern Nazi party. (because, let's be honest, that's what the GOP is now.)

You're agreeing that this is a political problem, but you're still putting the impetus and responsibility on the physician in that situation. If we're using the trolley problem as an example, the person holding the switch to choose between the 5 people in harm's way, or actively switching it to one person who currently isn't in harm's way....the switch just changes the track direction. That person doesn't have access to brakes, or a "derail" option. The physician in that situation has to choose between actively leaving one person in harm's way, or allowing many people to suffer down the line.

Personally, I don't have kids, I'm not going to have kids, and it's just me and my husband. I don't have a whole family of lives to ruin by getting into legal trouble by running afoul of this, but I don't blame the physicians who do have a lot to lose. Also, I know enough about the legal system and how medical documentation and coding work to make it tough for the hypothetical prosecutor to pin things on me. Hell, I'm still a student and I'm thinking up ways to play this horrible game they've set up, and I think some of my solutions will be pretty clever if I ever have to use them. I will not be sharing any of those ideas, but I have quite a few of them.

You do realize that the traditional Hippocratic and Osteopathic oaths forbid abortions, right? A lot of physicians adhere to more modern versions, but if you're going by the traditional Hippocratic oath, you're just talking out your ass about something you don't actually understand the context and consequences of.

Edit: It appears that I should clarify some things. I do not agree with the original Hippocratic or Osteopathic oaths. I refuse to take them, and have instead written my own for myself and my firmly held beliefs. Abortion and euthanasia are expressly forbidden by the original oaths, and there are still quite a few physicians that point to those oaths to excuse themselves from violating conservative religious beliefs on those topics. I support the right to abortions, and the right to die with dignity. It's still important to recognize that the original oaths that many physicians (old and new) ascribe to forbid these, and that they will use those oaths as an excuse to violate patients' rights in favor of their own beliefs.

So, is this you saying that you will put your freedom and your family at risk to help someone?

To be clear, I am a third year medical student that wants to go into emergency medicine, and I'm already looking for ways to challenge this kind of bullshit to protect my patients. Thankfully, I live in a state that has actually set itself up as a refuge for reproductive healthcare (Minnesota), but I'd just get more creative about it if I lived somewhere else.

I'll put my money where my mouth is...would you? I want an actual, honest answer that takes your own life and situation into consideration.

Well, we are the North Star State.

And they are not mutually exclusive.