Afib, which commonly causes palpitations, should be seen in the ER if you can’t get in to your PCP that day. Could be caused by a lot of things and a work up is warranted including lab work, echo, etc if new.
Afib, which commonly causes palpitations, should be seen in the ER if you can’t get in to your PCP that day. Could be caused by a lot of things and a work up is warranted including lab work, echo, etc if new.
If you in the US, you’re primary care doc’s office wil havel an after hours number to call if you’re not sure. Unfortunately you’ll likely be told to go to the ER if it’s heart related because we have to err on the side of caution since we can’t evaluate you very well over the phone. Urgent cares are hit or miss since they’re staffed mostly by mid levels who may or may not be well trained but they can handle sore throats/colds, simple cuts/infections/foreign objects, STD testing, etc. depending on their facilities. I’ve been to one without basic labs which is crazy. I’d suggest calling you doc’s office first to see if they have acute visit slots that day. A lot will.
Yeah, a good physical therapist will push you past your limits. From personal and professional experience, mental limitations will hold you back when you’re rehabbing. With my less uptight patients I’ll tell them physical therapists don’t give a shit about your pain and discomfort, they’re there to get you better. I love those fuckers, they do wonders.
I’m sad to see you go.
Is it actually hilarious? Did you fall out of your chair, laughing so hard you shit yourself? Or are you just performing for the internet, being the cool guy? Looking at your profile you’re trying hard to be “the smart guy”. Or you may just be a sad troll, lashing out in an attempt to foist some of your misery on those around you but also avoid the consequences of your actions. Hard to suss out with certainty but happy to keep fucking with you if you want to keep going.
You may be right a out that but I’ll keep trying. I’ve seen some truly egregious care provided by midlevels who were hired for primary care because hospital admins only care that midlevels can bill 80% of a physician but they only have to be paid a third of a physician salary. Unfortunately people aren’t able to differentiate between all the people in scrubs that they see so I recommend supporung Physician for Patient Protection , a great organization that lobbies against unsuper mid-level practice.
And as for chiropractors? I have little against them except for neck adjustments and adjusting childre. Necks are fragile and so are the arteries in it and kids are the just straight up flexible, they don’t need placebos to feel better.
I disagree with the use of doctor for anyone who hasn’t completed medical school and their field’s respective post-graduate training. I’ve seen the term watered down to the point that anyone tangentially related to a physician-led field uses the term. Chiropractors, nurse practitioner, administrators, etc. etc. It leads to confusion in patient populations. I’ve had patients in the ER tell me that their nurse practitioner was equivalent to me in temrs of training which is absolutely not the case. I finished 3,000 hours of clinical rotations by the end of med school and another 10,000 hours of training by the end of residency. Patients are lucky if an NP has 500 hours of clinicals before they’re hired to provide “primary care”. The training an optometrist has is specialized but not to the level of an opthalmologist so using the same term muddies the water and makes it difficult for people to discern the difference.
I worked with European PhDs at the NIH and the impression I got was that they don’t use it regularly or even prefer it. Small sample size but at the upper echelons of their respective fields.
An opthalmologist is an eye doctor. They go to medical school and do a residency for extra training. Optometrists have doctorates in optometry meaning they do four more years of school after their bachelor’s. They can call themselves doctor because in the US that’s the convention for doctorate’s (in Europe ony medical doctors use the term). There’s avast difference in intensity, depth, bredth, etc. of training between the two. It’s easy to miss the difference if you’re not familiar with the system.
Well shit, I grew one town over from there. Pretty sure that’s right by our cliff diving spot on the Croton Falls Reservoir. I never went in it most kids in highschool knew some “facts” about that mine.
Fortunately CMS is rethinking the role of primary care and realizing we can save money if we’re able to provide high quality preventive care like we’re supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.
Oof this is definitely wrong. A blood thinner is one of the most important things whether a patient is taking or not. It’s the nurses job to let the doctor know whether the patient is compliant not only for medical reasons but for documentation. That’s outside the argument about profit in healthcare in US, that’s basic medicine. What if that patient falls and hits their head? Do we need to know if they’re on s blood thinner? What if they’re hemoglobin starts dropping? What if they need a procedure? What tif their platelets start dropping? Etc, etc, etc.
Don’t be a dick and not do your job, that makes your coworkers miserable and puts people in danger especially in medicine. I agree with burlit being and issue and chronic understaffing but be an adult and quit or move positions if you don’t like it.
It’s not that CPR doesn’t work, it’s that outcomes after resuscitation usually aren’t great. The study doesn’t disclose ages or neurological outcomes post-rescuscitation so that limits my interpretation but quick rescue and quick CPR is key in those acute, single reason emergencies. That isn’t to say in an emergency situation you shouldn’t try especially since you don’t know that person’s wishes. There are good outcomes but usually for underlying healthy people who had one thing go wrong. Think the athlete who’s heart stops on the field for some reason.
I’ve admitted at least a thousand people into a hospital through the ER and I tell everyone that it’s not like on TV. If you’re older, sick, multiple chronic diseases, don’t take care of yourself, etc. the chances of any kind of quality of life after CPR is limited. Death is terrifying and I understand them wanting to try but it’s just not realistic a lot of the time. We need better deaths in the US and more in-depth end-of-life conversations with our patients. That should be starting in the PCP’s office. Trying to discuss that with a patient in the ER who’s already scared isn’t ideal. I’ve seen patients with do not resuscitate/do not intubate orders on file change their mind when they’re suffocating and panicking then once they’re more stable immediately change their mind back.
Thanks, that looks legit, especially considering they got a Nobel for the process. Red blood cells wouldn’t work though, no genetic material to tell the cell what to do. Skin cells sure but deeper layers before they ditch their nucleus. The bottom layer of your epidermis is already made of stem cells that continuously produce new keratinocytes (skin cells). That’d make sense as a starting point for what they did. I’ve been in medicine for seven years and there have been all kinds of crazy claims made but researchers so I’m always skeptical.
Do you have a link for the paper that describes the process for converting blood into stem cells? Curious how they went about it because making red blood cells into stem cells would be hard since they have no nucleus and no DNA. I googled but couldn’t find anything about how they do it.
Couple of things it could be:
I agree with your doc (I’m a family med physician), don’t smoke if all of a sudden you’re passing out.
Fucking not 9lbs that’s for sure. Around 1/2lb usually.
But then you don’t get that cheese that dribbled out and sat on the pan and got crunchy and savory and delicious. Like caramelized cheese.
It’s really not the doctors charging crazy amounts, it’s the hospitals. MBA types got into medicine and squeeze it like any other industry. GI does a scope? Doc gets $200 for doing the procedure, facility gets $5k for a facility fee.
Oh yeah, a lot of common causes need to be evaluated plus we need to assess if the person should be on blood thinners due to the risk for a clot in the heart that can travel to the brain. I’ve admitted quite a few patients for new onset Afib due to their underlying causes as we didn’t think they were good to go home. Admittedly most people would be fine and we can be too cautious due to legal liability and physician anxiety over bad outcomes but considering the possible consequences, it’s not a terrible thing to do that.