Patient fell yesterday, unwitnessed, partially my fault(?) I can’t get the sound of the thud out of my head and seeing the patient face down. Been crying all day, feel sick to my stomach. Patient had a new brain bleed, AMS, left side down. Kept taking care of the patient for the next 4 hours of the shift while the family was in there crying. I was doing q15 min neuro checks to show my remorse and how much I really care. They were my patient for 2 days, we had good rapport and the family really loved me. The were crying and the one asked me why I didn’t stay with the patient. Doing the rest of the shift with this tunnel vision is fucking me up. This hasn’t even happened 24 hours ago and I feel this unprocessed trauma from the whole incident, I’ve been catching myself staring into space picturing the incident, zoning out at a stop sign or watching tv. I have to go back to work in two days and I’m terrified to see the family. I don’t know what to do or how to seek help. Thank you.

Hi guys,
After doing a decent amount of research, I stumbled upon the TPD disability discharge. I had been struggling to find constant work as I have been disabled due to CPTSD and the depression and anxiety attributed to it.
Since July I believe, the Biden administration changed the rules of applying that a therapist or registered state psychiatric professional can recommend you for this discharge. I brought it up with my therapist of 3 years. He has a Psych Doctorate and had never heard of it. I explained it to him and he filled put the form.
TPD discharge says that the practioner has to check a box that you have not worked for 5 years or you gave the potential not to work for five years at a level of consistency. There used to be income checks yearly but the Biden administration nixed those during Covid and made it officially null as of July. There also is no check to see if you are employed.
There is a 3 year probationary period where you cannot apply for more federal loans. If you do you may have to repay the discharge, or sign something prior saying that you are aware the future loans can not be discharged in a similar fashion.
The process took about 45 days on total from the submission of the application to the final discharge. It went from being submitted, and then an administrative forbearance was put on my loans for something like 4 years whilst the claim was being reviewed. Then the review process took a few weeks.
On a side note, forgiven student loan debt is considered taxable income by the government. Biden has a moratorium on the tax burden for TPD until 2025. This is mildly problematic as the the three year probationary period would put the tax burden into 2027 if you were approved this year. Let's hope that Biden is re elected and he will extend this moratorium in his next term.
When It was discharged I was relieved. If you read my one prior reddit post, it discussed how I got out of 260k in private loans though statute of limitation laws. I felt for a while that I was working the system, or guilty for what I had done. But I realized more recently that I was seriously disabled in my mental health, and that CPTSD had crippled me in ways I had not understood. Some disabilities are invisible and may not even be considered real by the person who has them. They are shamed for not achieving, being lazy, sensitive, broken.
But they are real, and they affect everything you do. If you are struggling because of severe mental health issues, 10s of thousands of dollars of debt on top of it is crippling! It can be terrible and painful for a neuro typical person, but having severe mental illness on top of that can make you immobile in your existence.
Pride is a tough cookie. You want to do the "right thing" and pay back your debt. But pride doesn't pay your bills. And a degree is an intangible concept that is there, whether you pay for the loan or not. No one can reposess your degree!
I have included the single page that my psychologist sent in the application for PTSD. It is a relatively long filing but only has a few pages for the borrower to fill out and the one page for the mental health professional to fill out. I have obviously redacted personal information and removed the doctors information for privacy reasons. One talk with a caring professional and about 20 minutes of work may bring you back your life! (Edit) I cannot post images in the sub. Dm me if you want the pics.
On a final note, credit reports!
I was on a 0 dollar repayment plan for tears before covid. I thought that having this discharge would hurt my credit, but all the positive credit history I had from the past remained thankfully!
If you read my other story, as I defaulted on my private loans in 2013, I had 280k in debt and a 420 credit score. As of today, because of the TPD I and some better financial intelligence, I gave a 710 credit score and am at net 0 on my student loan debt 15 years after graduating undergrad. Do what works for you, don't let anyone judge you unless they are willing to write you a check for the loans you owe. Then they can have a say!

You can call it brain fog, or a slow brain, heavy/stuffed head or whatever. I’m not sure exactly how to explain it better. It just feels like my brain is all webbed up and stuffy.
I’m a 26 male, 5’9, 65kg/143lbs
What I’m feeling right now: It feels like my vision is a bit narrower, looking around and focusing on things seems like a chore, I don’t have mental clarity and short term memory is slightly affected - I basically find myself zoning out and forgetting what I was about to do, only to remember it again a few seconds later. When i’m sitting working on my computer, my head feels heavy and it’s hard to keep steady focus, it’s better when I support my head with a hand or two (propping it up), similarly laying my head back on a pillow and using phone is easier as opposed to having it upright. Because of all this I have no motivation or drive to involve myself in complex tasks (my business/work related).
How I got here: All of this started when I got a flu, I had really bad dry cough, and coughing excessively started giving me a painful headache. Soon after I had mucus (snot) from my nose, it seemed dry previously but it eventually started coming up. This was almost 2 months ago now. I’ve had this stuffy head feeling ever since. When the flu symptoms subsided, I was left with a constant dizzy/vertigo feeling. Over time it got a bit better in the sense I felt it only when I woke up or occasionally throughout the day.
Now this webbed up brain feeling as I explained is there, i’ve also felt postnasal drip, my sinuses also feel blocked (family history of deviated nasal septum). My head also sometimes randomly sways in one direction for a split second.
I was going through my old reddit posts and found out that I’ve had a similar experience around 5 years ago, right after a flu. I was trying to find help then but didn’t get a single reply.
If someone knows what could it be and what are the steps to take, or any additional information is required from me, do help. Plus, if I have to get it checked from a Doc, who should I go to? An ENT? A Neuro? A GP? Or should I get some basic blood tests done first to rule out anything (vitamins, rbcs, iron, cholesterol etc)

Hi everyone!
First of all, as I am new here, I hope I don't break any of the community rules.
For context, I am a 21 year old M, with no history of migraines running in the family. Early January I had what doctors said was a migraine, woke up with immense pain behind the eyes and then when went to the left of my head and I also felt some nausea and vomited. My eyes were so red that day, my family was worried it could turn into something worse, but thankfully it was nothing. At the time my sleep schedule wasn't the best and wasn't wearing my glasses regularly.
Anyway, 1 week went by and everything seemed fine, but then i started getting these regular dull headaches and nose bleed, got worried and went to GP that sent me to brain MRI. MRI came back normal, which was a relief. Went back to GP and started taking Propranolol (40mg daily) which helped and reduced those dull daily headaches, or was just Placebo effect. In the meanwhile I had my first aura migraine while driving to work and had no clue what was that at the time, the migraine itself wasn't even that bad. I should mension that by that time I was still not wearing my glasses, but had my eyes checked, no major issues, but my last prescription was slightly off.
3 months or so of taking Propranolol, I was seeing progress, but I was still getting those days where I would wake up with a terible headache, if I overslept or underslept i had the same bad headache and I know that is a sign migraines but what the well, are you telling me I have to sleep like 7 hours every single day for the rest of my life???? Decided to head back to GP and asked for a neurologist of his recommendation, because while the dull headaches were taking some life quality away, I could live with them, what I couldn't do, is study. Right now I'm only doing some teaching classes, which are duable with an headache, but taking a masters with this dull pain will be the worst, and trying studying at night, without a good sleeping patern, Lord save me...
So I went to the Neuro, told all I could remember, although in 20 minutes of stress I can't remembetell all of this stuff. I said I had constant headaches pretty much 2 times a week 24/7, which was wrong, it is more like 3 or so, and he looked so suprised and felt so sorry for me. He diagnosed me with migraines but is this migraines? My pain is 24/7 and is constant and dull, doesn't hurt like the ones i read on this subreddit and I don't have the necessity to go to a dark room and lie down. That probably just makes it even worst cause I'm focused on the pain.
So now I'm taking Topamax (100mg daily) and lowered Propranolol (20mg daily), and this first month or so has been the worst ngl. I think I've develop some new symptoms. I had crazy pain behind the eyes, especially when driving, but that has gone better since I got my new glasses. I still get pain behind the eyes in some strange situations like when doing my beard, when I'm facing the ceeling but looking at the mirrow (idk how to explain this better). I get the dull headache more frequently and with more intensity (on the temples, and right and left side of forehead). I think there are muscle tension headaches not migraines. My neck pops like crazy and the time I went to an Osteopath not so long ago, she told me I had misaligned cervical vertebrae.
Nowadays I can sleep whatever hours i want and I dont wake up with those bad headaches, I just always wake up with a feeling of pressure on top of my skull, which is so strange and I think i didn't have before or Propranolol was taking care of.
Visually I am kinda always seeing horizontal tv static lines? Idk if that makes sense but if I look into a wall I can see those, especially after looking at my computer screen (60 hz), but that can just be anxiety related, because since this headache cycle looks like an infinite loop.
Anyway, got a medical appointment this Friday and will try to explain all of this to him, so all this text will come in handy :)
I wanted to know your opinion and if someone has gone through something something similar.
Lots of headache free days for you all and sorry for the bad english!

My 12 yo spayed cat Inky had been acting off since September. Took her to the vet, they didn’t find anything specific. They did a needle aspiration of a mass on her left hip in house, said it looked like a benign cyst.
Fast forward to this year. Inky would pace a lot, but she and her brother were spending lots of time in the basement to avoid a new cat we rescued. She ended up in the hospital for not doing well once, and came home. Vets didn’t know what was wrong.
She somehow jammed herself behind tall cabinets and a stone wall and broke some ribs. Not sure if she fell from the top or walked behind them, forcing her way back. The vet during a FU visit to check her ribs suggested we get the hip mass removed and a tooth with a cavity. Did another fine needle aspiration, sent it out. Tissue was connective tissue, could be cancerous or benign. Would need to be biopsied. But also suggests we see a neurologist first in case her pacing and vacant behavior was neurological.
The neuro ordered an MRI, which found an inoperable brain tumor in the middle of her brain, third ventricle. It’s 2.2 cm x 1.8 cm x 1.9 cm. The radiologist mentioned it might be a Choroid Plexus papilloma or carcinoma. Neuro said radiation is only thing that would treat it. Palliative care otherwise. Prescribed Prednisolone to reduce swelling and pressure on the brain, which helped a lot. He said she already outlived the usual survival time for cats with a brain tumor. I made an appointment for a RO consult just to see what they think.
However, the more I think about radiation, the less appealing it is. I’m unsure about the stress and strain on Inky. She is becoming more nervous the more she goes to the doctor. Her appetite seems to be decreasing. We have to give her Sub-q fluids now, as she seems to not be drinking on her own (my guess, don’t see her drinking, and she seems to get dehydrated) And I wonder how much it will help.
Would you recommend getting the consultation and possibly doing radiation? Or just palliative care and euthanasia when it’s time? How much does SRT help? (I will not consider regular RT, too many treatments)

I am desperate at this point. I don't want to be reaching for any diagnosis, but this has become so complex and the decline in function is significant. I wrote a lot and apologize. But I want more so possibilities and the next steps that my neurologist needs to take now that I am out of the hospital, because scans are completely clear. He did scans and they were clear too. But I am not okay. My neurologist is very involved and caring, so I want to help him if possible. Hospital is a no go as I will be in a legal matter about my stay.
Also, any suggestions on getting in to see major medical school specialists earlier because of this major decline?
Started in December, but I had a severe viral infection in September and October that I never felt fully recovered from. Autism, ADHD, Migraines, possible Narcolepsy and Insomnia, and possible Ehlers-Danlos Syndrome, with diagnosed Hypermobility Spectrum Disorder.
With that said, my neurological symptoms lead me to be intubated in the ICU after major unresponsiveness. Hospital stay was NOT helpful. But as already known, clear scans, CT and MRI. Had multiple ones. EEG (at the time) were normal
Overall, I think I am having weird migraine attacks causing the unresponsiveness because it always starts with the stapedius muscle having painful spasms, ear fullness that leads to sharp inner pain on the left side, to pressure and mild swelling on the left face, severe head pain and throbbing, and then rapid loss of function all the way to loss of all reflexes. Then I slowly get better. BUT the weird feeling on my left side never fully goes away. It started with my left eye only having double vision but both do now. Eye doctor says structurally everything is fine, but the examination caused a trigger of the first unresponsive episode with a build up of intense pain to loss of full function (including reflexes) from Wednesday to Friday.
I have major quick fatigue upon standing to the point that I am trembling severely by the time I wash my face and brush my teeth. It feels like my legs don't work right, and I am extremely dizzy and unstable, and my back has a worsening herniation of L4 and L5 that was caused by extreme hypermobility. My Ortho is so worried, he sent out referrals to major medical school spine specialists, but the wait is so long, we are going to a brain and spine specialist here, who said they may only be able to help some, but don't know much about my issue. Going on June 4th.
At this point, because of the medical abuse done by the hospital, I am trying hard to avoid it. I was discharged while in a medical episode and mocked when I had them as if I was faking. Just to note, I am a person with previous major psych issues from misdiagnosis and incorrect treatment. Since being treated with Adderall, I had a full time job until I lost it to these issues.
I just want my life back. I went to vestibular balance PT to work on balance exercises and it caused major Vestibular Migraines even doing tracking. I failed all three balance systems. And I ended up stopping because it increased symptoms to the point of painful spasms in my stapedius muscle that was so violent, it cause a hemi facial spasm and led to 2 ER visits in a week. Since then, my face has never felt the same.
I think a lumbar puncture is the next level as all scans are clear, but the decline as become majorly disabling. I spoke to the hospital about it, but they moved my diagnosis to psych without obtaining any records, and discharged me with no plan. EEGs come out normal, but neuro said it may not catch it.
To note, Keppra seems to be helping some... But I still feel overall constant pain and pressure on my left side. I can't feel wind, or pain, but can feel touch pressure on my left side. I failed my corneal reflexes repeatedly while awake and conscious with both my eye doctor (structurally clear) and Neurology. Plus, my left side feels weaker and can see a extremely mild droop on my lip. And it was noted my left eye was dryer than my right and my eye doctor suspects my eyelid is affected. I lose my other reflexes completely up to no gag reflex when unresponsive.
To continue, shortness of breath has become disabling as well. My brain seems to beg for air even though I have 100% O2 at times and then other times I will go from 98 to 88 from less than 2 minutes of walking, as noted by my provider's urgent care.
Curious about an unseen brainstem issue? Was told by my eye doctor that my symptoms are seen with cranial nerve 5 and 7. Neurologist agrees with his findings.
Also, I am terrified of going back to the hospital as I was denied basic and medical care during my week stay. But when would family look into taking me once the unresponsiveness hits? Vitals tend to stay pretty stable, but I can't protect my airway. Even though my family doctor sent me to the ER after an emergency appointment and contacted them to specifically alert them of my arrival and symptoms, they used IV narcan without our knowledge and wanted to discharge me with more decline in function until a second doctor check my gag and then they intubated me.
What's next and how can I get it done? This all started with my left eye twitching like crazy in January for 3 weeks. Thought it was stress and now I am slowly declining in function. And I just want answers on how to get quicker care because it feels like I am dying.

I was feeling inspired by another user's post about new grad struggles and I've seen it come up a lot in discussion that nurses (especially new grads) don't feel comfortable with when/how to contact providers. I've also seen several posts in residency about inappropriate pages from nurses. This is something I also struggled with as a new grad, so I put together a guide with everything I wish I knew when I started. It ended up very long but I hope this helps at least one person feel more confident with contacting providers.
As always, follow YOUR hospital's policies when it comes to notifying providers and the associated documentation. If you are ever in doubt, page the provider, especially if there's a safety concern. This is meant to be a guide to help you feel more confident in contacting the provider, not a replacement for your nursing judgment.
I'm personally passionate about improving nurse-physician dynamics and communication and making life easier for new grads, so if you have any more topics in this area you'd want a write-up on let me know! I'll try to follow up with questions and comments later today.
Why are you contacting the provider?
1. Because you have an order to notify them.
Before you do anything else: Assess the patient. Do NOT just page the provider "BP 192/100. What would you like to do?" This is where your nursing brain is important. Hypertensive? Assess for headache, chest/back pain, blurry vision, etc. You need to put the abnormal value in context, report that focused assessment to the provider, and understand how it might affect the patient. To an extent this just takes practice, but doing a focused assessment will help you answer the follow-up questions the provider will likely have about the data.
Who to contact: Usually the primary team or the team that wrote the order to notify. Your primary team should be responsible for managing things like abnormal VS/daily labs and is kind of the "hub" for the other consulting services. Depending on your hospital, primary might prefer to notify the consulting service of abnormals themselves, this kind of varies based on your hospital culture.
How to contact: This takes some practice but If the patient is asymptomatic, usually I will just address this when they round. Your facility might have a policy on how quickly the expect you to notify for abnormals. If you see the provideteam making their way down the hallway, it can usually wait the 20-30 minutes until they make it down to your patient's room. You can also page the night coverage a quick FYI or page the team if they've already rounded.
What to expect: Notification of an abnormal does NOT mean they necessarily need to treat it immediately. A BP of 172/90 is worth notifying the provider if that's your order, but don't expect an order for hydralazine. If there are no symptoms of end-organ damage they need to alter the patient's daily BP meds which can take a day or two to straighten out. Also consider that if you take the patient's BP before they take their morning meds, it's going to be high. In this case you already have your intervention. Or pt desats to 87% while asleep, resolved with 2L NC, and no s/s infection? Cool, FYI page the provider that information, don't expect further response or intervention, and move on with your shift.
Troubleshooting: If the provider appears annoyed that you notified them, ask if they would like to modify the notification parameters in the order. This is their job but a lot of newer residents (if you're at a teaching hospital) have a poor grasp on the concept that we legally have to notify per the order. They're still learning too.
Side note: I think new grads (myself included) make the mistake of thinking that we have the job of emergently treating every abnormal VS and lab value (asymptomatic hypotension with MAP >65, low-grade tachycardia, fevers, elevated WBC, etc.) when often we have an incomplete understanding of the physiology and literature around treating these problems. As a new grad I literally made myself SICK with worry because nursing school made me think I could kill a patient by forgetting to let the provider know the WBC count went up by 2 points or that a patient with a resting HR in the 90s got tachy in the low 100s for 15 minutes. This is insane, don't be like me.
2. Because you need an order.
Before you do anything else: I NEED you to check your orders and make sure they don't have a medication/intervention already available for this. You would not believe how many pages docs get asking for things that they've already ordered.
Who to contact: Say you need a PRN for agitation/pain/constipation, an order for a diet, or something dumb like SCDs/home CPAP/nasal cannula O2. 95% of the time it's going to be primary team. Again, your primary team is your hub for day-to-day needs. I usually start with them. If I'm questioning who to contact, I'll start with primary team and also add "would you like me to ask [consulting service] instead?"
How to contact: Text or page for semi-emergent things, address when the provider rounds if it's something silly like SCDs. If I need some miralax and know the team is going to round in a couple hours, I'll wait for rounds. If the patient is on the ceiling or writhing in pain, I'm looking to get that addressed quickly.
What to expect: In general, the speed at which I need a response depends on the severity of the situation. This varies widely by institution but I'd expect to wait 5-30 minutes for something "emergent" vs 30mins-several hours for something "non-emergent." Hospital providers are understaffed just like us and have to triage requests. You know how it feels when one of your patients is coding and your other patient is screaming at you for ice chips? When you send 3 pages in an hour because your patient needs a suppository, you are ice chip guy to a provider that's in a code, responding to a rapid, or admitting a patient in the ED.
In general, you get a couple of responses: a) They just give you the order, cool done. b) They don't give you an order for a good reason (loading up nana with benzos and antipsychotics is bad), this is a great time to discuss alternate interventions to keep the patient safe and comfortable. When you page, it's good to have a plan B in your brain to suggest if they decline your first request. Good clinicians will explain their rationale but understand they don't always have the time. c) They don't give you an order for a bad reason. If this is the case AND I'm concerned about the patient's immediate well-being (i.e. patient is on the ceiling, screaming in pain, etc.), escalate up the chain. This is a great place to utilize your charge nurse for help and finding who is your next step as this can vary widely based on whether you're at an academic institution or not. d) Sometimes they might ask you to use an already scheduled medication and just give it a little earlier. This is also a great intervention to suggest if you have something that works on the MAR already.
3. You are questioning an ordeintervention.
Before you do anything else: Google it. Why is this medication ordered instead of this other one? How long do we need to keep doing q1h neuro checks on stroke patients? Probably 50-75% of the time I get my question answered by Dr. Google, PubMed, and UpToDate. A side note: your institution likely has free access to UpToDate and it is a GREAT resource for learning the basics of medicine if you're ever uncertain about the best practices for management of a particular condition.
Who to contact: The best person to ask is going to be the provider who wrote the order, but again your primary team is a great resource.
How to contact: These are great questions for rounds! These are NOT great questions to page about at 0200 when you're finally sitting down to look through the chart.
What to expect: Most places I've worked, people were happy to offer a rationale as long as they had time. I'd say this is especially true at teaching hospitals. YMMV heavily based on your facility culture. This kind of collaboration is great for your learning and patient care!
4. You have a concerning assessment finding +/- You want the provider to come see the patient.
Before doing anything else: Ask a more senior nurse or your charge to lay eyes on the patient. They might be doing something totally normal that you've just never seen before. Or they might have started treatment for a problem (i.e. ABX for PNA w/ increased O2 needs) but you're not quite sure how long is "normal" before you should start seeing improvement. This is why having senior nurses on staff is so important and it's a shame we let people burn out of the bedside so fast, but I digress.
Who to contact: Again, you usually can't go wrong with primary team and "would you like me to page [consulting service]?" This can vary widely based on the problem. Problem with CBI or retention? Probably calling urology. Acute neuro change? Probably calling neuro and a code stroke.
How to contact: Don't be afraid to page here if you have a legitimate concern! If I don't have a specific concern but still want them to come check things out, I'll say "Hey I'm seeing xyz and I don't know that there is anything to do right this second, but I have a bad feeling. Could you come lay eyes on the patient when you have time? 95% of the time your doc is going to be appreciative and reassuring and will just come see the patient. This is a great approach for wounds that are starting to look funky (assuming this is a new problem and not mentioned in the notes) and other assessments that aren't grossly abnormal but you feel like you're seeing something weird. A lot of times it's nothing or it is something that hasn't quite crossed the threshold to treat. More than once, that gut feeling was correct and the provider was just as concerned as I was.
What to expect: Highly depends on the circumstance. I aim for a call back within 30 minutes to an hour unless it is a stroke or something immediately life-threatening. For "bad vibes, please come check on them" type of pages I'm looking for a call back within an hour but not expecting them to show up for maybe in the next 3 hours, no rush unless I have something concrete going on. The best advice I have here is to go with your gut and don't be afraid to call a rapid if you feel like the patient's well-being is at risk and you aren't getting a response quick enough.
An addendum here and for #4: Consider your hospital's geography when you are requesting someone to be physically present. For some reason, every hospital I've worked at had units or a small specialty sister hospital that was technically part of the main hospital but miles from the ED. If the person you are requesting is down in the ED or on another floounit (because they can have patients across multiple units), consider that they might be a half mile away in a different building.
5. Patient/family are demanding to see the doctor.
Before doing anything else: Figure out what the family or patient is expecting the doctor to do. Do they just want an update? Cool, would a phone call later in the day suffice? Rounds are going to be in an hour and the whole team will be here, would that work for you? If they're upset about whatever the plan of care is, let your knowledge take you as far as possible in explaining interventions to the family - sometimes you don't know enough and have to page the doc. That's okay! Do they have a ton of needs/goals of care to discuss that would be better suited to a care conference? Great, let me get you in touch with case management so we can get everyone together for a sit-down. Sometimes patients and families are just ridiculous and insist on seeing the doctor in person anyways, but at least attempt to filter these requests.
Who to contact: Probably your primary team, unless they're specifically asking for neuro/renal/GI/whatever. If they're demanding to talk to the surgeon I usually tell them that isn't going to happen (because they're obviously doing surgery), but would be happy to get the primary team to come help explain things.
How to contact: You're probably going to have to page/text them.
What to expect: At my facility, 90% of the time I can get a doctor to the bedside for this type of problem within an hour. Sometimes they're busy with more emergent things, which is understandable. This is a shitty part of nursing if you have to deal with an impatient family/patient, put on your best therapeutic communication face and try to manage their expectations.
Other tips and tricks:

• Can this wait until morning? In lots of hospitals, the person covering is just a night float and they're responsible for a shit ton of patients as well as any new admits. They don't know the patient well and aren't going to be comfortable making huge changes to the plan overnight. Also your night coverage might be an exhausted and terrified intern. Consider the urgency of the problem and how long it's going to be until the primary team rounds. Unless the patient is threatening to leave AMA, I'm not paging at 0200 for a miralax order.
• Remember SBAR. "Hi this is Nurse MonkeyDemon taking care of Patient X, are you familiar with them?" PAUSE. You might be thinking "Why wouldn't this provider know anything about this patient?" The provider may have just come on to the service that day. They might be night coverage for 50+ patients. Be prepared to give a little run-down of why the patient is here, their history, the current plan, and recent changes to the plan in addition to your assessment and recommendations. At the bare minimum, read the H&P and the most recent progress note to get in the loop. This can usually be done in under a minute.
• Figure out when teams round. I worked ICU for most of my bedside career, so we had rounds in some form (roughly) at 0900, 1500, and 2100. This probably isn't true if you're on med/surg or stepdown, where your team may only round once a day at god knows what time. If you have a non-emergent problem (i.e. order for SCDs) and you know the team is rounding in 2 hours, make a note of it on your brain to address during rounds.
• Be succinct and try to cluster your requests, address things in rounds as much as possible. I worked nightshift for most of my career, and at the start of my shift I would glance over my orders and make a short list of things I wanted to ask for in rounds. A big one was melatonin/sleep aids (which I personally believe 99% of patients should just have as part of their admit order set). If your team doesn't round on nights, there is a high likelihood that your doc would STRONGLY prefer that page for melatonin at 2200 instead of 0100. Night rounds are also a great time to ask for things like decreasing the frequency of neuro checks. A little bit of planning goes a long way in making life easier for you, the provider, and the patient.
• Be patient with yourself. You don't know what you don't know. There's a lot to learn in the first year of nursing and the hospital environment is on an entirely different planet than the NCLEX hospital. Ask lots of questions, read UpToDate when you can, and use your resources. Physicians are your coworkers and learning how interact with them in an efficient way is a skill.

Hello! to start off I am 27 yo F. 320 lbs, 5’11”. I have been having some concerning symptoms that I cannot seem to get answers for. I will get random periods of an extreme faint feeling. (When I was younger I fainted a lot so I know what it feels like when you’re about to faint, for example, tunnel vision, lightheadedness, dizziness, rapid heart rate, etc.) These spells happen a lot when I am driving and after waking. It also sometimes wakes me up, Ill wake up sometimes very suddenly dizzy and almost forgetting how to breathe. Along with these spells, I am increasingly weak, I have been having muscle twitching and spasming in my legs and occasionally my jaw (one time so bad I bit my tongue so hard it bled). After these dizzy/near fainting spells (which are usually relieved by laying down) I begin to shake uncontrollably. I am always conscious though. These episodes have always been dismissed as anxiety. I have been to the ER, and had a primary for years that checked many things and never found anything. I have now gotten a second opinion at another primary and she has me being seen by cardio and neuro. the first neurologist I saw was under the impression I was having some sort of temporal seizure? she ordered a bunch of testing but I found out she wasn’t in network and had to go to a new neurologist. This new neurologist does not think seizures (as my primary and first neuro thought) and instead ordered labs for electrolytes (I drink electrolytes every day) and a brain MRI. I have yet to have the MRI but labs as usual all came back normal. (I can post all my labs if needed). She did an orthostatic BP and laying down bp was 144/91 and after standing 104:70. She said however my hr was not responding the way it should. could this be POTS? furthermore, I have had a cardiac holyer on for almost 30 days, an echo, a sleep study, as well as abdominal and chest CTs. What could be going on? what questions should I be asking? this is affecting my quality of life. i’m scared to do anything or be alone for fear of fainting or seizing. Thanks in advance for any advice.

Just a bunch of fics that I love. They range from really long, well written to just straight PWP. Find your preference, just make sure to read the tags. Some of them are pretty graphic
(fics marked with an asterisks are ones you should totally check out first)

Time Travel

Wear Me Like A Locket Around Your Throat by VivyPotter *
Lucifer by leontina
Before the Storm by orphan_account
But For You, I Did by duplicity *
Game On, Your Move by Ailora *
Full Circle by tetsurashian
Cacoethes by IneffableChaos
good night, darling by purplemineralwater
Earning His Notice by Lomonaaeren
How to prevent a War by CrazyJanaCat
Forever, Preferably by JoWithTheFlow *
At the End of Every Road by sassysquatch
love is touching souls (surely you touched mine) by ToAStranger
The Alchemy of Happiness by lovelyviciousxv
Promises, Promises by mosiva
To Kill You With a Kiss by Paimpont
Stars, Hide Your Fires by Audair *
Weave of Time by keidaught
It’s Just Revenge, Darling by DearClara
Someone Who Believes by MorianaBeldom
What Souls Are Made Of by Emeralds_and_Lilies *
Relativity by Ideasofmarch

Harry Raises Tom

What He Grows To Be by Severus_divides_into_H *
47 Days to Change (a translation) by snow_owl01
Growing Pains by Naomi_Riddle
Harry Riddle- Love is a different time by SquibNation10

Childhood Friends

Holly & Yew by LovelyLotus
His Gravity by Wiegenlied, You_Light_The_Sky *
Harry’s brother is called Tom by Ourliazo

Hunger Games AU

With a resolute heart by Act_Naturally *
Tomorrow brings them true by asterismal

Office AU

Kudosed, Bookmarked, Subscribed by maquira
letters of seduction (apparently)by purplemineralwater

Professor!Riddle

The Orphaned King by silenceinwinter2019 *
hook, line, and sinker by purplemineralwater *
Fault Lines by SofiaBane
Cruel Intentions by Katsitting

One-Shots

An Apple a day (keeps your crush not far away) by Odys_seus *
Baby, you’re a curveball by exarite
Black Roses Mean I Love You by nrnyx
Blind (to let you go) by exarite
Freudian Slip by maquira
In Which Tom Riddle Can't Stop Underestimating House Elves by asterismal
Don’t Fuck With Florists (They’ll Fuck You Up) by MayMarlow *
Rivalry by The_Fictionist
tautological by eleven_eaves
The Tired Beats the Reluctant by matoyo
We are Powerless (literally) by matoyo
Want You Back by RenderedReversed
malediction by eleven_eaves
An Influencer with Influence by kingsqueensroyalty
Anemone by A_Single_Cactus
Rings Around by wynnebat

Coffee Shop AU

And the Rest is Confetti by MayMarlow
Why is Roonil Wazlib? by remaya

Fake Dating

Pretend by temptresslove *
Set That Ball Rolling by Penmanner
we should just kiss like real people do by gryphonfeather
a star that burns bright by isisUnbound

Sugar Baby!Harry

Touched by lemonchase *
Sugar, Baby? by MonsieurClavier
anything & everything by exarite
Let’s talk sugar by asterismal
Pancakes by Divida
The Gift of Giving by tiigi *

Minister!Tom

Reporting for Duty by Alissia
Aphelion by TimaeusKosmou
His Darkest Devotion by Lomonaaren * [this one is also a soulmates AU]
Growing Old With You by Batsutousai
Love’s Loathing by The_Fictionist

Necromancer!Harry

In Willing Sacrifice by GeMerope
The Necromancer by MaeglinYedi
The Emperor and The Star by wynnebat [this one is actually Seer!Harry but I don’t have enough fics to make it it’s own category 🥲. Any recs?]

Slow Burn

Let’s Cross Over by Naomi_Riddle *
A Snake Named Voldemort by orphan_account
Again and Again by Athy
The Train to Nowhere by MayMarlow
The Darkening of Your Soul by Maeglin_Yedi

Omegaverse

Pureblood Omega Etiquette by temptresslove
Meeting the Parents by temptresslove
Depths of Desire by Gwendal_Wincott
The Act of Unity by temptresslove

Personal Favourites

(never) let me go by by Ailora *
Inevitabilities by EclipseWing *
If We Were Lovers by reggieblk
No Glory by ObsidianPen *
how large the teeth by MaidenMotherCrone *
The Root of All Evil Is Love by Crystia *
dawn of a death of a dream by eleven_eaves
Too old to be this young by Nadia_Castillo *
Diagnosis by MaidenMotherCrone *
Dripping Fingers by May_May_o_o
Consuming Shadows by Child_OTKW *
Hauntingly by ObsidianPen *
consumption by Laeveteinn
And the Living Will Envy the Dead by Severus_divides_into_H *
euphoria by MaidenMotherCrone *
a lion and a snake, sitting in a tree by thecunningserpent
The Language of Thorns by kaedeRavensdale
It’s A Masquerade, Darling by ChubbyPanda15 *
Butterfly Heart by The_Fictionist

What Plot/Porn Without Plot (PWP)

As the French Do by exarite
Serendipity by Alissia
So Perfect, Darling by youknowmevj
Call Me By Your Name by NeuroWriter14
Prison Blues by exarite
run your hands over my skin (kiss the bruises and begin) by Maven_Morozov

Author Appreciation

If you enjoy the Omegaverse, you should visit temptresslove on ao3
If you like Harrymort, you should visit ObsidianPen on ao3 *
If you like well written, long fics you should visit MaidenMotherCrone on ao3 *
If you enjoy Powerful!Harry you should visit Lomonaaeren on ao3
If you enjoy a fun plot, you should visit Ailora on ao3 *
Other personal fav authors: Child_OTKW, leontina, duplicity, purplemineralwater, ToAStranger, exarite, reggieblk, asterismal, thecunningserpent, Naomi_Riddle, Severus_divides_into_H, wynnebat, The_Fictionist, maquira, MayMarlow

I am aware that whartons jelly may or may not help neuro/ligament repair, unfrotunately like many on this sub I kinda have a "fringe" condition without many answers (cervical spine problems, gait issues, many neuro symptoms that go along with it) and willing to try things. Not completely despearte, and I'm not loaded, but there's an amount of wiggle room that I'm willing to experiment.
My question is, how do we know that the wharton's jelly that the provider injects actually contains live cells? I've seen criticisms from Regenexx, they did this study:
https://regenexx.com/blog/our-latest-paper-on-umbilical-cord-stem-cell-products-gets-published/
And in the blog post, they say "So bone marrow from elderly people has MANY MORE stem cells than Umbilical Cord products, which have NONE." However if you read the study, they only tested 5 manufacturers wharton's jelly, and I have never heard of any of those companies.
They didn't test R3, ways2well, clinics abroad or other big names, and regenexx is a big company that does bone marrow concentrate injections. No offense to them, but the very first step in checking for bias is to follow the money. I have done 3 regenexx procedures with good results, and I trust Dr. Centeno, but there's definitely a level of uncertainty in the details.
It can't be that hard to verify that there are living stem cells before you get them injected, and I assume the manufacturers know that patients are suspicious, how would I verify that? I'm even willing to pay for a third party test.
EDIT: So the study says the samples failed these tests:

• Post-thaw viability testing.
• Colony-forming unit-fibroblast (CFU-f) assays.
• Proteomics analysis.

My hope is that R3 and utah stem cells have already tested to make sure they aren't shipping dead or almost dead stem cells to inject into patients... and that seems possible to disprove with third party labs like https://www.wicell.org/ or universities.
If that's not done already, then there's some kind of market opprortunity to connect these dots from a third party to explore.
I'll call the R3 and utah stem cell doctors and see what they say, maybe talk to some univeristy stem cell labs to get their take too. More to come.

TLDR: my best friend has screwed herself financially since she split with her abusive husband, is constantly lying, and generally being a bad person.
I just found this sub bc I don't know where to turn about my best friends behavior. She got out of an abusive marriage around 7 months ago. Ever since then she's been making some questionable financial and moral decisions. I'm just going to list them out here.
For context, she had a really good corporate job that she lost due to some interpersonal issues with her manager. She did have a good case for retaliation, so the company agreed to pay her severance for the next six months when they let her go. It totalled around 40K and her last severance check was the first week of this month. She doesn't have another job.
She also has two young children that her grandmother watches regularly, especially the older one.
• She didn't pay her mortgage for 4 months, moved to a major city and rented an apartment (even more expensive than her mortgage payment) then acted surprised when her house went into foreclosure
• She manipulated her grandmother into loaning her the money to pay up her mortgage, promising she'd pay her back when the house sold. Then when her grandmother gave in (and went though hell to get a loan bc her credit is shot) she ghosted her for two weeks.
• Lied to my face about getting the loan from her grandmother. I know about it bc her grandmother called me worried about my bff bc she hadn't spoken to her since she gave her the money.
• Then my bff went and bought a whole podcasting set up, including an iMac and expensive recording equipment not even a week later.
• Went on a cruise with her new boyfriend (who I actually approve of) and missed her daughter's kindergarten graduation.
• Also while on the cruise, she got really drunk and flirted with a random stranger just to get her boyfriend's reaction and really acted a fool around all his friends.
• We let her borrow one of our cars bc when she left her marriage she didn't have one. They had just let her car be repossessed. And she totalled it a couple days ago, and swears she'll pay us what we want for it.
• I personally feel she's manipulated her new boyfriend (who is also a good friend of mine) into moving in with her bc of her insecurities, even though they've only been officially together for like three months. Now he's stuck playing daddy to her two kids and footing the bill for most things.
• She also used her grandmother's credit card (with permission) to buy a bunch of stuff after the split with her husband, including a new iPad, and promised to pay her back. Her grandmother said she hasn't been paid a dime and that was 7 months ago.
• She's starting a business that revolves around mental health, neuro divergence, and "evolution" and exaggeration her credentials in a big way.
• Generally exaggerating and lying to me about most things.
Here's the thing, I think she may be abusing her Adderall prescription on top of all of this. Or maybe that's the underlying cause idk. But she's stressing me out and idk how to talk to her about. She's constantly looking to me for sympathy and validation for the shitty situation she's got herself in, and I can't pretend to feel sorry for her anymore. Not to mention She has no idea that I've talked to her grandmother and know about the loan and how much she owes her.
I'm also concerned that she's going to get her new boyfriend into financial trouble bc he loves her and can't see past the honeymoon phase to see the truth.
How would you go about broaching the subject? Or what would you do in my shoes? Keep in mind, she's been like a sister to me since 8th grade. We've been through some shit together. We both had bad childhoods with abuse and trauma. And I know that's no excuse. I'm at a loss on what to do.

Okay here it is the ultimate ultimate step 1 write up from an average medschool graduate. This WILL NOT BE coming from someone who has been soaring through med-school. Most of the time it’s been a tip toe across the pass line so the resources I have used are aimed specifically for the underdogs out there just trying to round up that pass. So lets get this!
Exam day experience:
Brought everything in clear zip-locks so check-in would be smooth. They make you take out any tissue papers or papers from your food items so make sure whatever lunchables you prepare from home aren’t wrapped in that bcs you’ll be struggling to dismantle your sandwich in security line up from that. Otherwise the process was smooth enough the people at my prometric know you’re spooked enough so don’t bother you too much and guide you step by step.
Once my first block started the questions were long I was prepared because people have been ranting about that on reddit for weeks on weeks but was it anything out of the ordinary N O P E it was exactly like the new free 120 in terms of length like it literally felt like I was giving it bcs in terms of pacing myself and the time constraints it was the same thing to the dot!
So at home make sure you guys are well versed in practicing how to complete the free 120 on time. The length of the questions and tbh the approach with the longest questions that works best imo is READ THE LAST SENTENCE OF THE QUESTION STEM and skim the answer choices>> most the time I was running out of times on blocks and I did this and I didn’t even need to read the 30 liner opening statements on top and I could easily tell what the answer was just from the last line so keep this strategy in mind to maximize your testing time and skills!
Block 1 for me I would say was the longest and hardest bcs I wasn’t sure what I was supposed to expect due to this general notion of how crazy out of this world this test is. Its. Really. Not
Most of the questions tested on the blocks that followed were NBME PATTERNED single liners straight like just tell me the mechanism of action of this or that and stuff that you see over and over again to the point you stop revising like oh this I know at the back of my hand. Please don’t do that bcs I was like sitting there trying to recall the most basic of stuffs bcs of a concept I had stopped revising months ago bcs it was as simple abc. Its free points don’t lose them.
I’m not saying there weren’t wild questions on the exam but you could tell for the life of me no matter even if they gave me the internet I would not have been able to attempt those questions so I would safely say e x p e r i m e n t a l s and tbh save yourself the mental distress even during the exam you’ll be like O SHIT what was that cross-section or that graph ive never seen before what will I do MOVE ONTO NEXT BLOCK FORGET THE PAST you have so many questions to do so much room to make up for that odd couple questions you didn’t know.
My testing strategy was to not waste time on the wild wack questions I would never get but instead, go over the moderately difficult ones making sure I’m getting those right.
I didn’t have enough time to go over marked questions like maybe 3-4 on some blocks but per block, I would say easily I was unsure about a good 15-17 questions with a good 5-7 no idea what they were talking about and this is completely normal. So expect it going into the exam. Don’t be spooked.
There will also be question answer choices you will not know so don’t lose sleep on them and go with your gut on familiar choices as opposed to the wild answer choices bcs I came home and googled some I was like hMmMm never heard of that one before to mix it up let me select that. It was wrong .-.
There were a lot of neuro gross sections, some histo diagrams, not too many calculations let me address that on resources I used that helped and what would I would suggest to do more below:
Resources
>Highly highly recommend going knees deep into the mehalman pdfs esp the high yield arrows, endo, renal, NEUROANATOMY. If you have the time please skim the rest but prioritize these first.
>Bootcamp videos are good if you’re in your very initial stages of preparation. Or even as a revision tool I would say I used them to brush concepts I forgot during my last month. The subscription doesn’t cost a lot and some of the sections like renal rly helped sort out acid base disorders and the pressure-volume loops in cardio. Plus they have rly nice assessment tools after each video and sections that BnB doesn’t offer which I found super helpful too its worth a shot to see if it suits you instead of browsing through a lot of youtube content to find a source online.

Neuroanatomy: I printed out the cross sections from mehalman pdfs and any other I could find from UW, free 120, NBMEs so that I could go over them over and over again and get familiar with content. They show up fairly a lot and most are straightforward easy points so familiarize yourself with these cross sections. Also pull up gross locations of different views of other structures for e.g. thalamus etc just so that you know how things look from different angles and not just one.

>Biostatistics and Ethics:
Dr. Randy Neil on Youtube Videos
I also purchased the UW Biostats rapid review (This helped me with the ROC and Kaplan Mier tested questions that came up a lot)
I would highly recommend not to overlook the Bradford Hill Criteria that Dr Randy Neil discusses in his videos. Like it seems step 2 content but I T S N O T AT ALL pls pls revise these and know what the individual concepts mean and try to work out problems in terms of smokers and alcoholics. I think in terms of scenarios those are the safest ways to practice.
For the models of precontemp and contemplation questions every scenario always tests you on either smokers or alcoholics so sitting at home just practice these models and the way you would counsel.
>General Pharmacology:
Dr. Randy Neil again god send
>General Pathology:
Watched Pathoma and annotated it a long time ago didn’t rmmr much from the videos tbh but what I did was annotate any new info onto my FA don’t sweat too much tho if you don’t get the time to do them they are useful y e s but only if you’re struggling in your UW gen path blocks!
For a l o t of misc topics I used DIRTY MEDICINE for instance anything on the top of your head you think is hard and will be hard to retain. Dirty will have it. Familial Dyslipidemias, Hepatitis markers, Glycogen Storage Diseases etccc
What I would highly recommend to do is print out pages from the FA pdf of high high yield pages like that Immunodef disease table, or the gen path table and have it pinned on a soft board as your daily revision list. I’m not an Anki person so this is my make shift anki agenda for stuff ik will be tested and need to go over and over again because its just plain old memorization nothing wild or smart about it.
*If anyone is struggling with a particular topic please drop a comment below I’ll look through my notes and drop a link or a resource that helped me bcs there are too many to list down at the top of my head but tbh whatever you think you struggled with I have too and I found a solution to memorize it by some video online so please done hesitate*
Scores
UW % correct 55% (completed 100%)
NBME 16: 48%
NBME 26: 52%
NBME 27: 53%
NBME 28: 59%
NBME 29: 55%
NBME 30: 69%
Old Free 120: 62%
New Free 120: 72%
I know it’s a long and difficult journey but whoever is tested tomorrow or the next 3 days or next week or next month promise the test is super super doable it was nothing we haven’t seen before just need to believe in yourself and not freak out!!! YOU GOT THIS 30304723% OK
if you need any more help pls drop your questions in the comments below
Double also if you found this write up like even 0.2% useful pls upvote this post I need all the karma I can get my technologically challenged self-deleted my old account and it’s just been downhill on Reddit since.

Hi everyone. I have generalised epilepsy and tonic clonic seizures with elements of photosensitivity.
My seizures have been under control for 19 months now! On lamotragine for it.
My boyfriend of 9 months finally decided to tell me that every single night I twitch and jerk during my sleep. I said that’s normal, everybody twitches a bit when they fall asleep, but he said that it’s rhythmic jerking of my arms and legs in clusters which wakes him up and it’s throughout the night even when I’m deep asleep… every night.
I’m so tired all the time regardless of how much sleep I get. I rarely get any sore muscles, but sometimes I do wake up with aching arms and legs. I’m just wondering whether this is normal sleep behaviour or if something else could be going on epilepsy wise whilst I’m sleeping? If anybody else has experienced this, or has nocturnal seizures and has similar symptoms I’d be grateful for some info! Next appointment with neuro is in July for a check up :)

Hi everyone!
First off I want to express how thankful I am to have found this group. It has certainly become my safe haven when in doubt with the symptoms.
I am a 26M, and I, like many of you, am a hypochondriac. I hadn’t been for most of my life, but in the past year or so I had some friends diagnosed with cancer and I became a lot more on edge with my health. This led to a few visits to the dr starting in Sept 2023. One was to get checked for a blood clot (runs in family), another to get a lymph node checked, and another to get a lung Xray. All of which I was concerned about, but not at the level of concern I am with my twitching.
Early February 2024, I had suffered the health anxiety episode that led me to get my X-ray and ultrasound on some lymph nodes. After receiving good news on those, I felt relatively stress free for about 3 weeks. Start of March, I started noticing a twitch in my lower back when laying down and this included occasionally twitches in shoulders and legs. Two weeks later, it was completely body wide and is still persists. It would be a couple pulses in one spot then jump to another, all the time.
Last week (so about 2 and half months into twitching), I got an EMG and NCS and the neuro didn’t seem concerned and didn’t even pick up a fasic even though I have them multiple times a minute. I thought I’d feel more relieved but the twitching feels like it’s only gotten worse since. My left leg feels like it’s constantly vibrating/rumbling with occasional twitching. My arms feel like they vibrate when I’m using them. I haven’t noticed much weakness but the shaking freaks me out.
I got prescribed Dizeapam and gabepentin, and am increasing my vit D, iron, and mag intake. At the beginning of the year, I started drinking coffee and taking supergreens, both of which I’ve stopped the last 3 weeks or so to see if anything changes (they haven’t).
Do you guys have any recommendations on how to approach this moving forward? I’ve gotten so mentally consumed by it that it’s been hard to go about my day to day life.

words I ‘knew to write down’ 

 all my love, always 💋 

I will be graduating soon & I would like to join neuro side of industry. However as a new grad I understand my skills may not be up to par and I would need to develop skills in different units. So I decided to apply for PCU. I am being offered positions. However I feel like some of the offer are low. I am 77k in debt due to nursing school. I have one year experience in orthopedics as nurse extern & I’ll have BSN by mid July. I also have 10 years experience in hospitality & 3yr management in hospitality.
I was offered a 5,000 sign on bonus with a rate 29.50 plus differentials ($3/$3) & 2 year contract. So I’m looking at 32/hr, I am not fan of the 5grand lock in. That’s way too low for 2years. How do I go about negotiating fair pay? Everything is expensive now. Avg rent is $1400 for a one bedroom. Making 59k (before taxes) a year may not be sustainable in TX. I would like to start at 34/hr. Is this unrealistic for a new grad? Would it be better to discuss a realistic pay rate once I have my license? What tips would you suggest? Should I use salary.com to back up my claim for fair wages or is that unprofessional?! The ultimate goal is to gain a great foundation in critical care, take care of myself and pay off my debt.
Any advise is appreciated. Be harsh and tell me if I’m unrealistic. Maybe I need a reality check. Maybe you were in the same boat as me in this economy.

34 M here no family history of ***. I had a very sedentary lifestyle besides my 2-year-old son whom I carry and play with him as an exercise. I had a single twitch/tremor on my thumb 3 months ago while having stress. Then I searched for the possible reasons and of course, my anxiety started. I had maybe at most 5 twitches a day bodywide on the left and right (forearms, thighs, and shoulders) but no calves until today. One time I had twitches on my right inner thigh for a few hours. Today both of my thighs twitch for hours (dominantly my right thigh single spot). yesterday I carried my son on my back and ran while carrying him. Would anyone have twitches the same night and the next day due to physical activity? I went to 2 different Neuros after 2 weeks and after 2.5 months of my first twitch on my thumb. They only said hyperreflexia on knees bilaterally but within normal limits (I asked specifically after they said hyperreflexia). Both said there is no need for EMG and the last one who is a professor said moving twitches is not a worry and said no follow-up although I asked for it. Although at the time I was not twitching like today. All my blood tests came back normal. I just did my CK test and it was 140 even though I did 1-2 hours of walking per day before the test. (My country's upper limit is 190 for men). I have no weakness or foot drop. I can run, climb stairs, etc. I also started to train plank(3 min) and situps(1min 45 secs) to check my strength and weightlifting, seems I am not losing my strength. After plank, I got twitching on my pinky probably ulnar nerve entrapment :). I am afraid that it will progress slowly and I will get weakness in 6 months but I am very tired of worrying about *** and reading reddit forums and clinical trials every day. I wanted to ask if anyone had progressively increasing twitching and how they are doing now? I don't think anxiety and stress can affect me for so long.

Hello, looking for any support or advice here: We have 4 dogs currently, 3 rescues from ages 5-7 and our queen of the house Jack Russell, Abby, who will be 16 the end of September. We’ve had her since she was a baby and has been with us through every life event, multiple moves and has been one of the best parts of our lives! She’s had a remarkably healthy life. Last year at her semi annual well check (April 2023) the vet did a neuro check on her and indicated she was declining in many ways. Deep down we noticed things that were off, aimlessly wandering, circling, etc but she was still able to function fairly normal day to day.
These symptoms and more have progressed rapidly over the last few months. She’s now fully blind, has lost significant weight (you can see all her bones due to muscle atrophy head to toe), has accidents all the time (puppy diapers give her anxiety so that’s not a viable option), confused as ever, stares at the wall for periods of time, doesn’t interact with the other dogs anymore, etc. she does still eat (less than she used to and does still drink water too) we also have to carry her outside and down the steps every visit. This isn’t a huge deal but just another sign of a day in the life.
I’ve seen and taken the QOL scales and I believe it is time to peacefully let her go. My husband can’t cope with it and says she’s still healthy…his words…”I can’t fathom putting her down when her blood work comes back showing healthy organs”.
I can’t make him understand it’s not just about blood work. She is NOT the same in any way and it’s not how I want to remember her. I fear she will injure herself due to her frail state and although she doesn’t whine I feel like she is isn’t living any kind of good life.
I’m not sure what else to do. I’m obviously going to miss her terribly when she does pass as will her fur siblings.
Am I terrible/wrong for pushing this topic with my husband to get him to understand? He told the vet a couple months ago I’ve washed my hands with her. This is NOT the case at all, as I still care for her most every day when I’m working from home and he’s not here. I just can’t stand to see her live like this!
Thanks for listening.

Hi everyone! I was picked up as a JAG candidate in November. Since then, I have been playing the fun jumping through hoops game lol, everyone on the JAG side has been so helpful but my assigned recruiter.. less so.. lol.
I went to MEPS in mid-March, and had previously disclosed childhood asthma that has not been a problem since I was in elementary school (as in, I was on the National Team for a sport and played d2 sports). I also disclosed a one-time seizure, with testing that showed no problems or anything with my brain. It was two years ago, and I haven't had a problem since.
While I was waiting for my medical stuff to get approved, I had assumed I needed a waiver for those things, so I texted my recruiter to ask how the waivers were going. He responded that as far as he knew, I didn't need a waiver, and we were waiting for an approval. I responded that I thought I needed waivers for these two things, he then said "yes, but hopefully they are just approved right away and we don't need additional medical stuff." This was in mid-April. I have checked in regularly since. This morning he texted me to say, "we got your medical stuff back but it's denied. If you want to call and ask questions you can, but there's nothing else we can do". I responded back immediately asking for clarification and why it was denied, and he left me on read.
I wanted a bit of clarification, so I emailed the JAG accessions lady and she asked me to call her right away. I did, and she brought up the next steps of getting a letter from my Neurologist explaining that a one-time seizure is not epilepsy, and getting a Pulmonary function test, as well as writing a letter explaining my medical background and everything. She didn't seem totally hopeless at the possibility of this 'appeal' process actually working, so that's good, but I feel like it is probably a lost cause? Idk.
Essentially, does anyone know where I am at in the process? Was it essentially an immediate no that I cannot get waivers for? Do I have hope still lol? I know there is always the possibility of getting my congressman involved but I know that method doesn't work hardly at all. Just curious what is going on, or if anyone recommends anything to do ect. I have already gotten my Neuro letter and my personal letter ready, just waiting for a call back for the pulmonary scheduling. I hope to get into that test this week, then be able to send all the additional info in the next two weeks.
I also know that with the new Admiral previously DQ stuff is being reviewed, but I don't want to bank on that--seems like a long shot. I was sort of hoping that since JAG is not aviation or anything crazy that would work in my favor a tiny bit, but that seems to have been a pipe dream.
Edit: Formatting weirdly; fixed.

*UPDATE: her psych called me immediately upon reading my message through the portal. Apparently, there was a mistake along the way, and she was intended to take only 12.5 mg to start, but that wasn’t on the bottle. I can’t help but have horrific guilt about this. I was questioning if he had told me to start with a half tab, but the appointment was overwhelming, and, I like her psych, but he’s terrible with communication. (I know-not good.) I double checked the bottle, and it reads,”Take one tablet by mouth daily.” Not, “Take half tablet by mouth daily.” No wonder she feels like she’s losing her mind!!!! I’m so upset and angry, I have no idea where to put those emotions right now. She doesn’t need anymore suffering.*
Hi everyone. My almost 12 year old daughter started Zoloft 25 mg 3 days ago. She has some pretty severe PTSD, anxiety, depression, explosive emotional dysregulation and potentially undiagnosed ADHD. (I have a neuro psych eval set up for this month.) The first two days, she was on top of the world. She was bright, energetic, confident etc. It made me uneasy, because I was concerned we may be on the verge of a manic episode.
Today, she seems more depressed and is completely withdrawn. She doesn’t want to leave her room. She says she feels shaky and “really weird.”
I will obviously be in touch with her psych asap, but until I hear back, I’m looking for experiences and wisdom in this area. I am on meds for ADHD, but no SSRIs. Can this be typical, even if it’s the right med? Could it be just the dreaded “adjustment period?” How do I support her through it, if it is!?
Thank you!