Doctor/Patient

This blog is a way for me to explore that liminal space: managing Crohn's and PSC vs. juggling all of the responsibilities of medical school.

[odinsblog]

[animentality]

[ley-med]

When I quickly look up the dosing of a medication and all the internet would tell me is "consult your doctor" like yes yes I AM THE DOCTOR now help me

[beardedmrbean]

[whitecoat-bluegown]

lil work 

[wheresonichedgehogwnt]

Me when a specialist says something is important but "You should really talk to your primary care provider about it"

(I joke, it is approximately twice a year that I don't want to manage something myself as a primary care doctor, if that)

But seriously, if you're a specialist who is not going to manage something and you're worried about it enough to say something to the patient, maybe have you or one of your office staff CALL THE PCP DIRECTLY

[whitecoat-bluegown]

Reminds me of my 60 year old patient who has fibroids. Her cardiologist had to do a CT abdomen pelvis to eval a post-cath hematoma and absolutely PANICKED when he read “calcified masses in uterus.” He told the patient she might have cancer and got her all flustered. Sometimes it is better for specialists to stay in their own lane :)

[saprophetic]

a diagram of the knee

[saprophetic]

you understand this post better than like 80% of the notes do

[whitecoat-bluegown]

A new series: sh*t my patients say:

Discussing recurrent BV infections:

“Oh yeah, that’s been a lobster fest”

[nightclubsinger]

i’m strange but friendly so people tell me things

[whitecoat-bluegown]

This is my entire vibe in clinic.

[unsubconscious]

Upholstered skeleton chair by Sam Edkins

[rudywiser]

[doc-resilient]

everyone asking who is hospitalist, no one asking how is hospitalist 😢

[trooperrot]

Emil Melmoth sculptures. This guy is amazing.

[laineystein]

“No beds means no fucking beds.”

[intrainingdoc]

Do Individuals from Low-Income Families Belong in Medicine? (Yes!)

Recently, several attending physicians sparked controversy on Twitter by implying that low-income medical students or trainees should not pursue careers in medicine. While these tweets have since been deleted, the systemic injustices that they echo still ring in the highest levels of modern medical education. As a medical trainee from an impoverished household, I have spent almost my entire post-secondary education and medical training as part of an invisible demographic.

And finally, #1 of the in-House #Top10of2021: 

Amy Zhang, MD, MBA, wrote about the invisible demographic of medical trainees from low-income households. A critical read for #meded. 

https://in-housestaff.org/do-individuals-from-low-income-families-belong-in-medicine-yes-1903

[endcant]

idk if you all know this so im bringing it up but plume frequently costs substantially more than getting hormones from planned parenthood would. if you buy from plume without doing research into other methods, you could very well be overpaying by hundreds of dollars. there is nothing special about plume or its prices except that they are marketing themselves on social media

[what-even-is-thiss]

Also some endocrinologists will know how to hook you up with the cheapest pharmacy for hormones with your insurance if that’s the route you decide to go.

[whitecoat-bluegown]

And sometimes your friendly local family medicine doctor would love to prescribe gender affirming hormone therapy, too. If you find someone at a federally qualified health center, they are probably already well versed in finding the most affordable forms of medications for patients. 

[silly-bug-deactivated20230705]

Diabetes does not exist in a bubble. It is not only present when we check our blood sugar, get insulin, eat, etc.. It doesn't only become important during November. It does not only afflict the one with the diagnosis. It does not go away at a certain age, or with enough exercise, dieting, or support. There is nothing that is enough with Diabetes. It is not a silent bystander, but a constant and nagging presence demanding attention under threat of death. It is clawing and screaming and kicking and fighting. It is oozing, infecting, contaminating.

There is not a single part of my life that has not been altered to fit this disease. There is not a single person in my life who hasn't seen and felt the affects. There has not been a single day in thirteen years that hasn't been a war in my mind and body.

I have lost so much. Not only from the disease, but the stigmas surrounding it. I have lost jobs because of ablist supervisors that couldn't handle the fact that I'm chronically sick, as in ALWAYS sick. I have lost friends that expected me to be better by now, I mean, why can't I just control It? Why can't I just do what I need to and get better at this? I have lost mental security and faith in myself from medical professionals bullying me and demanding perfection while they refused to do anything proactive to help me because diabetes is a -totally- manageable disease and shouldn't be an issue! Ever! Why are you complaining so much? WORK HARDER!! I've lost trust in anyone, because so many sided with anyone else over me at first and instead restricted and monitored me and still blamed me when it didn't work because that is how Diabetes is treated. I lost years fighting to be heard and helped by people who insisted they were helping and even when they find something else wrong that seemed to be causing the issues, it's still somehow my fault. I've lost peace of mind and privacy because I can't leave my house without someone staring at my sensor, scars, or when I'm injecting, or offering unsolicited advice about cinnamon, okra, and yoga. My life is public property as far as they're concerned.

Why does support for Diabetics end as they enter their teenage years? That seems to be the point where support and resources turned into blame and shame for me. Doctors stopped being gentle and started demanding perfection.

This is a dangerous thing and the way that doctors treat adults with Diabetes needs to change because it's not linear and it is a difficult, unrelenting disease that lasts a lifetime. Piling trauma of isolation and gaslighting blame onto something that's already so fucking horribly traumatizing is absolutely disgusting and dangerous. I can't stop hearing their blame and pointed fingers anytime something is even slightly off, Diabetes related or not. Dishes aren't done? IT'S NOT THAT HARD, DO BETTER! Feeling sick today? WHAT DID YOU DO TO CAUSE THIS?! Haven't heard from a friend in a while? YOU'RE NOT DOING ENOUGH!

It doesn't end and I find sometimes that I wish I never survived diagnosis, or refusing to eat or move when my blood sugar is finally perfect and stable.

The standard for Diabetes care needs to change. We need more resources for adults with type 1 (I specify type one here not only because that's my diagnosis, but also because I've seen a bunch of support groups and resources for either adults with t2 or children with t1. We are falling through the gaps), easier access to things like CGMs, insulin pumps, and insulin itself, a better widespread understanding that Diabetes, no matter what type it is, was never a sugary coffee or a slice of cake, and for other diabetics who have it easier along with medical professionals and caregivers to understand that not everyone is the same and diabetes is hard and there's not always a clear cause and effect, that sometimes diabetes is just hard and it's okay.

This post is ranty, messy, convoluted, and probably doesn't have a linear train of thought, but there ya go. Happy Diabetes Awareness Month. Let a diabetic you know and love know that they're amazing and their disease is hard and it's okay to not be okay.

[whitecoat-bluegown]

When you're postcall, and you step out of the hospital, and it's pouring rain so you now it's gonna be the best day to sleep all day