#pcp = primary care physician

[billa-billa007]

PTs in the primary care space with Dr. Katie O'Bright

Physical Therapists (PTs) are healthcare professionals who specialize in treating individuals with physical limitations and impairments. They play a critical role in helping patients improve their mobility, function, and overall quality of life.

[drmarshallbahr]

Dr. Marshall Bahr Linkedin

https://www.linkedin.com/in/dr-marshall-bahr

My linked in profile, click here

[the-bad-batch-baroness]

Health Update

First, I want to say thank you to everyone who reached out or commented on the latest installment of Where's Mommy? to wish me good health. I am so grateful for all of you 💚

However, the health issue I'm currently dealing with isn't due to a virus or bacteria, and there's a possibility it won't get better.

A little history.

Back in 2022, there was a two week period where I felt like my blood sugar was dropping, and I was very symptomatic. There was a moment where I slumped down a wall at work because of it, and they had to dump sugar packets from the break room into my mouth to rouse me. It was a very scary time.

After those two weeks, I went to my Primary Care Physician who ordered blood tests and had me purchase a glucometer to test my blood sugar several times a day. However, during the two weeks she had me do this, I never got a reading below 70, and the same symptoms did not develop as they did prior. My blood work came back clean, and without a reading lower than 70, my PCP dismissed it and told me I was having anxiety attacks, lol. She told me to come back if the symptoms came back, and they never did.

Backing up a couple more years.

Without revealing too much of my medical history, I have a chronic illness called POTS (postural orthostatic tachycardia syndrome). It's a dysautonomia or a dysfunction of the autonomic nervous system, the system that controls all of the automatic functions of the body. It was caused by my battle with Lyme Disease in 2010 and is currently incurable. I was diagnosed with POTS in 2018, after being told for 6 years that I had anxiety, lol.

POTS is not a very well-known illness, but it's getting more attention these days. It garners a host of different symptoms, including tachycardia, chronic fatigue, brain fog, orthostatic intolerance, migraines, gut issues, syncope, dehydration, blood pooling, etc. Everyone's POTS presents differently, and most people with a POTS diagnosis live on disability. I made the choice not to.

Fast forward to 2024.

Fast forward again to this past Wednesday.

Well, I finally was able to get a POTS specialist in my state this year. A huge win! When I had my initial consultation, I had mentioned the low blood sugar episodes in 2022 and asked if it could be related to POTS. The doctor told me that they don't see POTS patients having low blood sugar issues, but we're concerned enough to refer me to an endocrinologist. Another big win!

I had my consultation with the endocrinologist, and he ordered more blood tests, some of the same tests as before, and some different (y'all, they took like 20 vials from me). He also gave me a CGM (continuous glucose monitor) to wear for 14 days so they can track my highs and lows to see if they can catch anything.

Well, the next night, my blood sugar dropped below 70, 20 times, and 55, 9 times. Which means I was woken up 9 times throughout the night. I got only about 2 hours of sleep, and still had to go to work the next morning. But, once again, it went back up by itself without any intervention from me.

Y'all, it caught A LOT in just the first day, actually night. My blood sugar dropped below 70, 11 times, and below 55, 4 times while I was sleeping. Now, because anything below 55 is considered critical and could be fatal, there is an alarm that cannot be overridden and will sound. It sounds like a smoke alarm. So, I was awoken 4 times.

The odd thing is that my blood sugar dropped, then went back up on its own. I didn't eat or drink anything. Blood sugar doesn't really do that, so I thought it was odd. This also begs the question: If I'm asymptomatic at 53, then what level was I at in 2022 when I had symptoms? Honestly, I don't want to know.

Here is a nifty graph!

All of the red is considered low blood sugar, below 70, and anything close to that 50 line is considered critical low blood sugar. And again, I did not eat anything during the night.

There are four major anomalies with my low blood sugar occurences:

Most cases of hypoglycemia are seen in diabetics, I am not diabetic

Most cases of hypoglycemia seen in non-diabetics are sporadic, mine are consistent

Hypoglycemia is normally corrected by consuming sugar, mine auto-corrects

When blood sugar drops, it creates symptoms, I do not get symptoms

There are only a handful of things that can cause hypoglycemia in a non-diabetic and even less consistently at night time. The doctor has already ruled out insulinoma (insulin producing tumors in the pancreas), so that leaves even less, and also the good old "we don't know what's wrong with you".

I'm not going to lie. This whole thing terrifies me. There's no telling how long my blood sugar has been doing this, and it only takes one dip below 50 for me to slip into a coma and die in my sleep. Luckily, my blood sugar does this crazy autocorrect thing, and I haven't died yet! Humor makes this easier.

Right now, I'm emotionally, mentally, and physically exhausted. Adding this on top of my already difficult life with POTS has been hard to cope with, and I'm crying a lot.

Hopefully, I'll get results soon, and my endocrinologist can figure out why this is happening and how to manage/fix it if it can be managed/fixed. Maybe I've got a completely new illness, and you'll find me in a medical journal! Wouldn't that be something.

Anyway, thanks for the continued support. I have a lot of IRL support from friends and family, but while I go through this process, I may seem distant, my posting might be sporadic, I may not keep my fic posting schedule, etc. And when I have an update, I promise to let y'all know!

Much love 💚💚💚

Steph

[skynapple]

No no no but I just thought of the FUNNIEST saddest thing. If you choose any of the other LI's over Zayne,, him as your primary care physician (PCP) and having to ask him to prescribe birth control....

[bomberqueen17]

adderall day 1

I'm not going to have any particular deep thoughts about this, but I feel like I should write stuff down. Several people have advised that.

I still don't know how much this is going to cost me, as my insurance couldn't be verified and I'm going to have to do messy things probably to find out. But I've got the pills in my hot little hand, 16 of them, and a follow-up appointment, and perhaps by then I'll know what this is actually costing.

It seems that it varies wildly how people manage to get ADHD dx's. Many many PCPs will not diagnose it or prescribe for it. It seems extremely gatekeepy to me, and not in a helpful way. my own PCP, as I describe more and more of my struggles to get healthcare in general, is being revealed to me to be less and less of any kind of a good fit-- she just seems baffled by everything I say. She asked if I have heartburn, for example, and I said, truthfully, oh yes, if I don't eat regularly, one of the ways I realize I've gone too long is that I start to have heartburn. So I've learned to be conscientious about my eating schedule, and eat small meals and snacks at regular intervals throughout the day, and that has cleared up the problem. And this actively baffled her, she was like "i've never heard of anything like this", and I can't imagine what she thought I was saying. Does no one else in the human race ever get queasy/stomach-acidy from going too long without food? Especially eating heavily and then not eating for a long time afterward? That's the worst for me, so I avoid that. I highly doubt I am the only person ever to experience this. But she seemed convinced that I must not know what heartburn is.

That's just one example. So. If I can get my head on straight at all, I am going to start looking for a new primary care physician. I'm sure this doctor is fine, just not for me.

(She is obsessed that my fasting blood glucose levels are too high. I read an article about it, in the 2010s sometime the CDC decided that 5.7 was a new worrying number (I don't know what the units are, but 7 is what people with well-managed diabetes shoot for), and now they were going to declare this new number "pre-diabetes" and start medicating it. The WHO has refused the concept of "pre-diabetes", pointing out that about 2% of people with this number wind up developing full-blown diabetes whether medicated or not, and that's about the same number of people who develop diabetes without having had this diagnosis, so it is in fact not any kind of reliable indicator of looming diabetes, so it should be referred to as "elevated fasting blood glucose levels" and not the new fictional "pre-diabetes". But there's money in selling that medicine, so American doctors are encouraged to make this diagnosis. And my doctor has put it into my chart that she plans to start me on Metformin if this number does not go down.

I'm refusing that. Medicate me for diabetes if I develop diabetes. I can be annually screened for it just like anyone. Sure, keep an eye on it! I take this seriously. But i am not getting medicated for a condition the WHO thinks is fictional. Thanks.)

Anyway that was a digression.

I'm hoping to at least make a start on dialing in my meds with this online guy, so that when I switch PCPs I can show up with the ADHD treatment as a fait accomplit and not have the new PCP throw a fit. I might try it with the current one too-- "Idk you told me it was incredibly complicated and insurance doesn't cover it so I went to my insurance company and they sent me to this guy and it wasn't complicated at all and I'm responding super well to the treatment so I guess this is what I do now?" but I am just anticipating her throwing a fit of some kind, since she is absolutely convinced I have major depressive disorder and has been trying to get me to go back on Celexa, which did me so much no good that I cold-turkeyed off it and gave myself horrible brain zaps. Don't fucking do that guys.

(It was with this same practice! It's on there, I no-showed to an appointment because I had so little executive function I wasn't even able to keep track of it! And she's still like yah medicating u for depression is super what's going to work. ma'am i have never been suicidal but I remember being on Celexa and most of it was my shitty life situation at the time but mostly it is a gray expanse of despair and ineffectualness, and getting inexorably fatter whilst starting to develop an eating disorder about it, and getting benched by my roller derby coach despite exercising myself to constant exhaustion and performing better than I ever had on the track because she saw my spreading waistline and assumed I was slacking off, and anyway. Yeah no.)

So anyway. I'm letting myself be stream of consciousnessy because it seems right. I had a reasonable breakfast, a lot of water, some coffee, a multivitamin, and my first pill about an hour ago, and am now ensconced in the recliner with the cat because the cat insists. I have started to feel.... kind of... like my throat feels kind of dry so I'm drinking more water, and I just got a little bit not quite dizzy and am acutely aware of all my eye movements, so I guess that's notable.

OK the plan. I would like to someday be able to make to-do lists, that's a medium-term goal. Meanwhile I'm still doing narratives of how i'd like a day to go. I have fallen off that a bit; I've been trying to do not a bullet journal but a just regular day planner in this new year (i got something on clearance off amazon lol) and mostly what I've used it for is as a diary post-hoc, writing down what i got done, and making little notes of what I want to get done, because otherwise my memory wipes itself and I don't know what I did all last week either. I fell off it this week because Dude was out of town and I was off kilter. But I'm going to fill back in what I can remember-- I'm keeping track of what meals I cook, what exercise I do, things like that-- and hope to keep it up going forward.

Routine, I hope, is what will help me.

Today. It is rainy today. I didn't get some of my stuff done while Dude was gone because of course the list I made would have taken six weeks of work, that's how my lists go. But I did get a lot done, so I'm going to write all that down. And today it is rainy, so I can spend time in the basement. What I want to do is empty out all my nice baskets I use to tote craft things around, and re-fill them with more curated selections. I think one basket for like, all the sewing tools, just all of them, in one place, and then another basket that is like, all of the embroidery supplies, and then a container that is An Adequate Selection Of Thread and also machine-sewing supplies? maybe? and then Active Projects can go into a third container that may or may not travel with me. Anyway, thinking about that is a work in progress.

I need to pack for my first trip of the season to the farm. I need to put away all the supplies from painting the kitchen, because I am finally officially totally completely done with that. I need to then tidy the kitchen counter and there's a little wooden cart that used to have our coffee stuff on it and I've been using it to dump all the shit and assorted project detritus from the ongoing painting on, and I need to then move that cart somewhere once I've put away all the things on it.

That seems like a reasonable amount of things to expect to complete today. OK I need to get out from under this cat because I have to pee now. All right. She'll be fine she just wants the chair really.

Yah ok i really gotta pee and dude is in the shower so i'm going to go get dressed and dance around a little lolsob. wish me luck.

[huntersmoon1]

Can a heart surgeon also be a regular doctor?

Cuz as far as I know a PCP (Primary care physician) is a regular doctor people see for yearly check ups,med refills, and stuff like the Pap test women get every 5 years.

Something I recently had done for the first time and I hated every minute of it.

Wait does that mean Zayne’s had to give Mc a Pap test at least once depending on her age?! 😳

[divineslcyer]

Art & Commission Signal Boost

So this passing week, we discovered an infection in my mom's foot after her appointment with her PT (Physical therapist). We went straight to her PCP (Primary care physician) upon noticing her foot looked darker in shade, like it was properly bruised. Now for the past two months, my mother's ankle hasn't shown much progress in healing but from what I understand with diabetics, it takes longer than average to heal. At her PCP, we learned her foot likely has an infection, and had to go to Mercy ER for because of the pain in her foot and infection, it was raising her blood sugar levels to higher than normal rates (i mean 300+ high) which is VERY unusual as my mom's been keeping to her meds and learning to stabilize her sugar levels.

Due to the urgency of the situation, travels, buying food outside since we hadn't had the means to go to the store yet, and my being busy tending and monitoring her, I've had to use up the funds for some of my other bills instead. So I'll be linking here my art commissions and graphic commissions for those who can help or are interested in buying work. I accept payment from Cashapp, paypal, and Zelle.

Here's some examples of my newer graphics, mainly character style psd's and dash icons;

and for those who want simple character/dnd busts, I do have a special for $50 that are like so;

Otherwise other commissions are available, slots are open so feel free to dm me here or on my other socials, even discord if interested. Please boost and reblog, as I am actively looking for work to help, takes a moment but means a lot! Thank you!

[horrifically]

HE SAID "PCP?" I SAID "YOU MEAN LIKE ANGEL DUST?" HE SAID "NO, LIKE PRIMARY CARE PHYSICIAN." I SAID "ARE YOU ON DRUGS? FUCK I LOOK LIKE I'M INSURSED? I'M GETTIN OFF THIS FUCKING BUS"

[thejoysofdessert]

Boy do I sure dislike the physician covering my PCP sending in a script for 1/4 my normal count of pills that make life worth living. Luckily, my primary care doc will likely be back in January. I have 32 pills to ration through January.

[roguemonsterfucker]

What is PCP? I only know of the drug that everything was blamed on in Buddy when the cops and media needed a cover story

Primary care physician

[indigo-a-creeping]

Hi, I’m slightly panicking because I have my top surgery scheduled for two months from now and just yesterday they told me I need to be medically cleared by my primary care physician. I called my PCP’s office today and they can’t get me in in time. I frantically called a few places to try to get an appointment with a doctor. I have one that said someone will reach out to schedule my first appointment to establish care but because k have to wait up to 48 business hours, I may not find out till Tuesday when they’ll even be able to see me, as they may not be able to see me in time either. I’m so anxious right now, and was wondering what this process was like for you or if you had to get medically cleared by your PCP.

Oh friend, I went through the same thing because I scheduled my surgery over 6 months in advance, and then just a few weeks beforehand they said I needed a PCP clearance and bloodwork and a mammogram!! My doctor wasn't able to schedule an appointment until AFTER my surgery date, but I explained my situation to the scheduler and they managed to get me in with a resident beforehand. Bloodwork was easy from there, and I had to call around a little but managed to get in a mammogram after a few tries (which you probably won't need if you're younger).

It was super stressful, but I managed it. You will too!! You're doing great! Keep trying, keep calling and bothering people about it, and be sure you let them know that you're doing this for a scheduled surgery.

[trexalicious]

Random possible cost savings AKA Did you know: Please check with your Doctor and insurance plan first, but two of my doctors accept/use Apple iPhones for specific scans. My primary care physician (PCP) allows people with iPhones to use them for EKGs instead to save money as they give very accurate readings. Additionally my podiatrist uses his to scan veins in the legs and feet also saving on certain ultrasound expenses. If you have an iPhone be sure to check out what medical tests you might be able to take advantage of to save some money...

[faeriekit]

The last addition for Gentle Genie <- this kills the man (me. maybe tim a little bit too)

If you invite me to your funeral, I promise a kickass eulogy.

Drake Manor/Genie side note: Tim's emergency room-turned-short-term-hospital-stay is probably the first time he's seen a PCP (primary care physician) since he was a toddler. That's the only reason Tim finds out he's nutritionally deficient. If he'd been neglected (or, well, more neglected) any longer, none of this would have been caught by any sort of authority. 😃👍🏽

[getoxycodoneonlineordernow]

Oxycodone Work, Uses, Warnings and precaution

Oxycodone prompt delivery tablets, cases, and oral arrangement are utilized to ease extreme, intense agony (torment that starts unexpectedly, has a particular reason, and is supposed to disappear when the reason for the aggravation is mended) in individuals who are supposed to require a narcotic aggravation drug and who can't be treated with other agony meds. Oxycodone broadened discharge tablets and stretched out discharge containers are utilized to ease serious agony in individuals who are supposed to require torment prescription nonstop for quite a while and who can't be treated with different meds. Oxycodone broadened discharge tablets and expanded discharge cases ought not be utilized to treat torment that can be constrained by medicine that is taken depending on the situation. Oxycodone concentrated arrangement ought to simply be utilized to treat individuals who are lenient (used with the impacts of the medicine) to narcotic prescriptions since they have taken this sort of drug for somewhere around multi week. Oxycodone is in a class of meds called sedative (opiate) analgesics. It works by having an impact on the manner in which the mind and sensory system answer torment.

How does Oxycodone work?

Oxycodone doesn't deal with the whole body. Maybe it follows up on specific tissues in particular the cerebrum stem(respiratory focus), medulla(the hack focus), muscles of the understudies, resistant framework, endocrine framework, cardiovascular framework, and gastrointestinal plot.

Oxycodone(its dynamic parts) goes through the blood boundaries and breaks down in the circulatory system to arrive at the designated tissue. On arriving at the designated tissues, the medication fools them into accepting that the torment has been diminished to a similarly low level.

How to use oxycodone?

Oxycodone is available as an answer, a concentrated arrangement, tablet, case, a lengthy delivery tablet, or a drawn out discharge container. For the most part, the arrangement, concentrated arrangement, tablet, or container is taken each 3-4 hours regardless of food yet the drawn out discharge tablets are taken after 12 hours regardless of food, and broadened discharge cases are additionally required following 12 hours yet you ought to take it with food. Your eating routine in the wake of taking these drugs ought to be something similar. Take oxycodone as per the medicine by your primary care physician, over the top use can prompt compulsion or now and again demise.

Basically swallow the pills with the assistance of water(do not use something besides water). Try not to trust that the pill will break down in the actual mouth and don't pulverize it. Assuming you utilize the nasogastric tube, illuminate your PCP before the treatment. It isn't encouraged to swallow pills through the NG Cylinder.

On the off chance that your primary care physician has encouraged you to take the case type of the drug however you find it hard to swallow, then you can basically open the container and sprinkle its substance on delicate food like yogurt or pudding. Promptly swallow the combination. In any conditions don't store the blend for sometime in the future. Doing so can cause the response of dormant parts.

On the off chance that you endorse a concentrated arrangement and it gets thick to swallow, you can utilize a limited quantity of juice to blend it. Try not to involve grapefruit juice as it is receptive with the Oxycodone medication.

Warnings and precautions

This medication has a profoundly habit-forming drug in it. You ought to constantly keep away from the excess of this medication. It ought to be gotten in a protected spot far from the compass of kids and ought not be given to any other person as this is a criminal behavior. While you are going through this medicine you ought to continuously avoid any liquor. This can demonstrate lethal or may seriously harm your cerebrum. Involving weed in any structure can likewise prompt serious outcomes as this can prompt falling in your pulse levels to exceptionally low and can cause trouble in relaxing.

Work with no hardware or avoid the driver seat when you have taken this medication. This medication causes dizziness which can prompt mishaps assuming you are doing things like this. Before you begin taking this medication, enlighten the specialist regarding your clinical history particularly whenever you have any breathing issues or emotional well-being issues. More established grown-ups may see a few serious impacts subsequent to taking this medication. You ought to be cautious with the fluid admission as well. 

Try not to take fluids with high sugar in you and stay away from grapefruit or its juice. It can cause serious responses with the idle fixings.In the event of pregnancy, this medicine ought to be stayed away from or ought to be completely under the specialist's management and the equivalent goes while breastfeeding likewise as this medication can get blended in with the milk and can influence the newborn child. The Newborn children that are taken care of with Oxycodone-contaminated milk are probably going to experience the ill effects of sedation and respiratory misery.

Do not use this Oxycodone for any other medical condition or do not share it with anybody else it is an illegal offense.

[gender-critical-analytical]

finally took the time to force myself to find a new primary care physician, took three days of calling around, but I now have a female pcp, and an appointment set for early january! there's a practicing female gynecologist at this location too, so now I just need to find out if she takes my insurance, and if so, schedule an appt with her

[minotaur-in-my-labyrinth]

"What do you mean you're managing your mental health symptoms with alcohol? That's so unhealthy!"

"Well you see, I don't have to schedule an exam with a Primary Care Physician, wait six weeks to see said PCP so I can get a referal to see a Psychiatrist, schedule an appointment with said Psychiatrist wait another six weeks to see said Psychiatrist, who then writes a prescription and sends that to a pharmacy, where I have to drive to see and wait while they fill it out to purchase alcohol."

"But it's-"

"Not healthy. I know. Tell that to our healthcare system."