let’s talk about medical literacy, med ed, and harm reduction✨certified yapper✨
Joined January 2020
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Nights has really tested my patience and kindness on little sleep and to the point of exhaustion. It’s taught me the importance of automation when it’s 5AM and you’re intubating someone, and most importantly it’s taught me to trust what I’ve learned over the years
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started going to therapy and it’s so rough explaining my life to someone, who knows if it will be useful tbh but we’ll see
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dr. simply serotonin, PGY-1 retweeted
I’m a doctor who helps people through really hard things, and I need mental health care to cope with that.
Putting this out there to help break the stigma because I once needed to hear these words.
dr. simply serotonin, PGY-1 retweeted
I’ve always thought emergency medicine is the most difficult specialty. Not just to train for, but to practice. No appointment, no history, no time, and every gap in the healthcare system eventually walks through your door at 2:00 am.
Dr @grahamwalker just announced he’s leaving the bedside after 20 years. His essay, “Always Open. Already Full,” explains why. The ER is the only part of healthcare that can’t say no, so it absorbs everything upstream, and the people working there absorb the rest.
Worth reading if you work with, or depend on, an ED.
dr. simply serotonin, PGY-1 retweeted
Most people who stayed on tirzepatide for more than 3 years kept nearly all of their weight off. About 95 out of 100 had normal blood sugar at the end, even though every one of them started with prediabetes.
Prediabetes means blood sugar is higher than normal but not yet in the diabetes range. This new analysis in Obesity Pillars followed 690 adults with obesity or overweight and prediabetes from the SURMOUNT-1 weight-loss trial who took their weekly shots consistently and lost at least 5% of their weight.
Their lowest weight came at around 21 to 23 months, about 19 to 26% below where they started, depending on dose. From that low point to the end of the study, the average regain was about 8 to 10 pounds.
7 out of 10 regained less than 5% of their starting weight and held on to about 95% of their biggest loss. Their blood pressure, cholesterol, and blood sugar improvements mostly held too.
Some drift after the lowest point is expected and usually does not undo the health gains. Only 8 out of 100 regained 10% or more. Their blood pressure benefit faded somewhat, yet 91 out of 100 of them still had normal blood sugar.
dr. simply serotonin, PGY-1 retweeted
You can disagree with me.
You can tell me you think my differential is wrong.
You can recommend a different plan.
None of that requires being unkind.
funny life update but I added an additional 2 years to my residency by picking up another specialty which is very unsurprising of me!!
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if you do say this (bc I say this all the time) follow it up with like, “currently supported on x of Levo, x of epi, etc” bc it shows yes they are… “stable” but that it’s more nuanced. every attending wants something different and just gotta take it in strides.
"Vital signs are stable" can be used to describe a dead person. Please be more specific. - one of my attendings in training.
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dr. simply serotonin, PGY-1 retweeted
ICU Hot Takes:
About once a month, I get that call from the ED.
The patient has an Hb of 4 g/dL, and the hospitalist, the ED attending, or both aren't "comfortable" admitting them outside the ICU.
I get the concern. A hemoglobin of 4 gets everyone's attention.
But can we agree on something? We admit patients to the ICU based on their physiology, not a laboratory value in isolation.
In fact, when I'm told that a patient with a very low Hb is hemodynamically stable, my first thought is that the anemia probably developed gradually, even if blood loss is the cause.
Of course, a normal BP doesn't exclude ongoing bleeding or compensated shock. Context matters. But often, this is a gradual Hb drop that the body has had time to adapt to.
The Hb tells us how severe the anemia is. The patient tells us whether they need the ICU.
#FOAMcc #FOAMed
booked my first therapy appointment in over two years. residency is hard, the weather is changing, and I should probably figure this out earlier rather than later🫠