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medgremlin

@ medgremlin @midwest.social

Posts
5
Comments
505
Joined
2 yr. ago

  • 🐆 Right-wing trans woman finds out "gender-criticals" cannot be reasoned with

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  • I am very glad that you were able to get your own care and didn't have any bad outcomes. On the other hand, I've had cis-female patients go to naturopaths or chiropractors to get estrogen and/or testosterone pellets for peri-menopause symptoms and they had no idea what the risks were. In the emergency department, I've had cis-female patients on estrogen replacement therapy that was not well managed show up with DVTs. Cis-male patients on supraphysiologic testosterone are at risk for several different kinds of organ failure along with a drastically increased risk of heart attacks.

    I don't think that trans patients are terribly likely to harm themselves with DIY HRT, but having hormones available OTC is going to lead to a lot of cis people getting sick or getting killed by taking extra hormones to try to fix their problems because scammers and quacks have convinced them that hormones will magically fix all of their problems.

  • exam cheating

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  • A huge piece of a physician's medical training is knowing what questions to ask (as well as how and when to ask) to uncover the sneaky things that aren't apparent on the surface. For example, as a 4th year medical student, I had a patient in the ER that came in with shortness of breath, fatigue, and chest discomfort. There were a couple hints of red flags, so I asked more questions that didn't seem like they were related at all. Was he having unintended weight changes, night sweats, or changes to his bowel movements? The answer to all three was "yes", but he had no idea why I was asking about that when he was there for breathing problems. I had a suspicion that he was having complications from metastatic cancer, and I was right. The resident I was working with hadn't even thought to dig into those other niggling suspicions and was more focused on cardiac and pulmonary causes of chest pain and breathing problems.

    I can almost guarantee that a nurse practitioner wouldn't have asked those questions either. I keyed into some very subtle signs on his exam which prompted me to dig deeper, but NP's aren't even really trained on how to get a deeper history, let alone when to do so.

  • 🐆 Right-wing trans woman finds out "gender-criticals" cannot be reasoned with

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  • I'm going to push back on OTC HRT because of the health risks. Supraphysiologic estrogen and testosterone can both have lethal side effects, so correct dosing and monitoring for health complications are essential components of trans healthcare.

  • exam cheating

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  • As a patient, you do have the right to refuse to be treated by anyone. You may have to wait for a physician to be available, but no one can treat you without your consent and you can always ask for a provider's title and licensure.

  • exam cheating

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  • The AI alleviates the process of critical thinking though. I make my own review notebooks for my boards and for clinical rotations by taking the time to figure out what's important and what I don't know to put those things in my notebooks. I write these out by hand on paper, so I have to be judicious about what is going to actually be important, and just the process of making those priorities helps me to have a better understanding of my own deficiencies.

    Making a good study guide requires critical thinking skills, and if that gets outsourced to AI, that means the critical thinking isn't being done by the human that needs to learn that skill.

  • exam cheating

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  • Nope. They can (and these days often do) go straight from their nursing degree to an NP program with no real work experience.

  • exam cheating

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  • The problem is that most people don't double check or they check a couple things then think "good enough", and turn off the critical thinking part of their brain. That's how lawyers ended up submitting a case brief with fake case citations. The "citations" look real enough, but to verify it, you have to go read the source yourself.

    This goes for people citing studies without reading them first. There are a lot of studies that squidge the numbers around to make things look better and you have to look for things like how they parsed the data for the results and conclusions. I've personally made pharma reps very uncomfortable by digging into things like how they did or did not parse complications by sex (ie one complication was parsed by sex, but the other was combined)

  • exam cheating

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  • Part of my concern is that APPs like nurse practitioners that have no supervised practice as part of their training are going to become even more poorly educated. Their curriculum is already algorithm-based, and because of the Nursing lobby pushing for more and more independence for NP's, they have dwindling physician oversight requirements (in some places a physician only needs to audit 10% of their notes and never actually lay eyes on the patient themselves.)

  • exam cheating

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  • Our board exams can only cover so much, so there are little things that can slip under the radar. Like I said in another comment, one of my classmates in medical school used Chat GPT to summarize the reading and it swapped the warning signs for 2 different neurological conditions, one of which is transient and can be fixed with medications, the other is one that can be lethal if not recognized quickly.

    Residency training will weed some of them out, but if they never see/recognize those zebras until they show up on the autopsy, that patient still suffered for their laziness and cavalier attitude towards their education.

  • exam cheating

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  • Medical student here. Some of my classmates did the same thing with summaries and study guides and it scrambled a couple of fine but extremely important details. The mistake meant that my classmate mixed up two presentations of neurological problems, one of which is transient and fixable with medications and the other is something that can rapidly become lethal if not recognized fast enough.

    RT's are precious resources for physicians, but the stakes for us fucking up are profoundly higher. (And if the RT does something wrong and the patient suffers harm, it's still likely to land on the physician to some extent in terms of liability.)

  • Trump’s MRI scan raises specter of secrecy in presidential health

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  • The problem is that the largest voting bloc is the Baby Boomers and they're just electing their peers because they refuse to recognize that they're old enough that they should have passed that baton about 20 years ago. Not that Gen X would be substantially better given their demographic's track record and history of lead poisoning during developmental periods, but it would at least be a slight nudge in the right direction. It's going to be decades before the Millenials and younger have enough votes to overcome the older, more conservative blocs, but that's not accounting for the proportion of younger people that have been entirely brainwashed by monsters like Kirk, Tate, and Fuentes.

  • She is making a GREAT point

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  • I'm absolutely not advocating for removing that option. However, increasing the options for male birth control is necessary for a wide variety of reasons, including allowing male partners to take the burden off of their female partner if she isn't able to tolerate the side effects or can't find a birth control method that actually works well for her. It is, in effect, another birth control option for women to be able to defer some responsibility to a male partner in a committed relationship.

  • She is making a GREAT point

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  • It's not a great option for more casual encounters or early in relationships, but for established couples that already have children and don't want more or are in a committed, trusting relationship, male birth control opens the possibility for the male partner to ease the burden of birth control effort and side effects.

  • She is making a GREAT point

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  • Vasectomies are a great option, but there are a lot of folks who don't want a permanent birth control so they won't get a vasectomy.

  • She is making a GREAT point

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  • Women and girls end up with suicidal ideation all the time when going through the trial and error process of finding the right hormone combination. There's dozens of different formulations of hormonal contraceptive pills and it can be extremely difficult to find the one that will work for you with the least amount of side effects.

    The suicidal ideation is so common that it just gets lumped into the fast-forward list of side effects alongside the potential for life-threatening blood clots and other things.

  • She is making a GREAT point

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  • I think men should consider the potential harms to their partner in their calculus. If a man participates in causing a pregnancy that results in serious complications or death, I would sincerely hope that he would be as devastated by the loss of his partner as he would by suffering the harm himself. If men can't empathize with their partner enough to consider the risks to her, then he shouldn't be having sex in the first place.

  • She is making a GREAT point

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  • Non-surgical birth control options for women tend to come with a lot of side effects and a number of risks that don't always outweigh the benefit. Hormonal birth control can cause tons of problems for the women taking them and some of them are associated with life-threatening side effects like increased risk of clotting leading to DVTs, PEs, and strokes.

  • She is making a GREAT point

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  • They've tried, but they can't get FDA approval because the men in the clinical trials aren't able to tolerate the side effects that pale in comparison to common side effects of hormonal birth control for women.

  • She is making a GREAT point

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  • Then the just and equitable thing to do would be to shift some of that burden to men to make things easier for the women that aren't able to "tank" the side effects that can include some life-threatening complications.

    I would also like to point out that the leading cause of death of pregnant people in America is intimate partner homicide, so the dangers of pregnancy can also be directly caused by the male partners. Y'all need to toughen the fuck up and get your shit together to do your damn part of preventing unwanted pregnancy and calling out the bad behavior of your peers that eventually escalates to things like rape or intimate partner homicide.

  • What's the most impressive video game mod you've ever come across?

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  • The ACE mods have single-handedly kept Arma 3 alive for over a decade. They add so much complexity to the game with so many options for customization by both mission makers and players. It's amazing to me how much difference the ACE modset makes to the game.