Toronto Veterinarian — Veterinarian shortage
4 years ago
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Isn't someone a Veterinarian on here? Deer Tick Help Needed
Comments (15)I'm sorry that the link I provided doesn't take credit cards - I suggest Googling for the item and finding another vendor that does if you don't have a Paypal account. May I offer another perspective on the Lyme Disease crisis? I know that many people really feel that a diagnosis of Lyme is a devastating, life-altering, health issue. I don't know them so I can't dispute their beliefs or health status, but I can state that I have had Lyme and been treated for it (twice) with a course of oral doxycycline, both times successfully and I do not have any long-term issues. My poor DH had neurological Lyme (positive spinal tap and Bell's palsy) and he was also successfully treated without long-term consequences, though in his case it required a PIC line and 30 days of very expensive IV antibiotics. In my rural, farming neighborhood, nearly everybody has had Lyme, at least once. We live in the upper Hudson Valley in a Lyme "hotspot". I find feeding ticks on me at least dozen or more times each year, despite fairly rigorous anti-tick behavioral precautions. (I use no sprays or insecticides on either myself or clothing.) I do keep doxy on hand to take prophylactically (single 200 mg dose) if I find a tick I don't know, for certain, has only been on me for a few hours. (That strategy has always worked well until the advent of Anaplasmosis which can be transmitted much earlier on. It is unknown how much time is needed for Anaplasmosis, unlike Lyme which needs a bite of 18-24 hours duration. In the case of the bite where I got Anaplasmosis, the tick could only have been on me less than 6 hours, and probably only biting me a good deal fewer hours.) If you live in a tick area you might consider discussing post-bite prevention antibiotics with your MD. (And as a side note unlike some drugs which can lose potency over time, doxy both loses potency and becomes toxic. So, please, don't use old doxycycline, ever.) Since I expect to encounter ticks, daily, I only rarely discover a tick that could possibly have been on me more than a few hours. (Example 21 bites last year, but only a single instance when I didn't know for sure that there was no way it could have been on more than 6 hours. And even though I took the preventive doxy for it, it was not a matter of having missed one after being out, just a failure to do a tick check prior to going out for the day.) Which brings me to my most important strategy suggestion: If you live in a tick area, or plan to go to one: do a thorough tick check BEFORE (or daily in the am in my case where I live in tick-hell) you go out. This gives you a tick-free starting point to age any subsequent bite. I also change out of my outdoor clothes after being in the woods or gardening as soon as I come inside. I never sit on the couch, or a bed, or on a rug in tick-exposed clothes - in fact I won't even sit down, except in the bathroom, in tick-exposed clothes. I wear tall boots (Wellies) for much of the year. I have separate outdoor coats for going out into tick areas and going to the grocery store. I routinely tuck all my layers in carefully: undervest into panties, turtleneck (with cuffs!) into pants, shirt into trousers, etc. I find only very thick socks will stop tiny nymph ticks, so I don't bother much tucking pant legs into socks. Working in my woodlot, I wear Carhardt bib overalls with slightly over-long legs that slop over my shoes. I never, ever, wear shorts, or sandals, or a skirt in a tick area unless I am prepared to be there for only a few minutes and then go in and strip down for a full tick check. My late Mother who was an ornithologist (wildlife biologist who specializes in birds), made for herself one-piece, zip-front overalls because she worked in very tick-infested areas of the world (with a whole different set of virulent tick-borne diseases.) I've been thinking of digging out her patterns and seeing if I can make myself some lightweight ones for summer this year as I anticipate being even more exposed than usual. I had to give up one of my most-cherished daily activities: walking out in the early morning with my cup of OJ to see what had come up overnight in my garden because I usually did this in my long nightgown. Ticks just adore hopping on to flannel and then hiding in the seams only to come crawling out the next night in my bed! Notwithstanding my fairly elaborate anti-tick strategies, I want to point out that a tick bite, even a diagnosis of Lyme disease, is not necessarily an enormous health crisis. True, some people seem to find themselves engaged in protracted issues, but most people do not. There is a substantial, and thriving, cottage industry promoting long-term Lyme disease problems. Ordinary, straight forward, evidence-based, medical care in most cases is more than sufficient. Don't assume that just because you've heard of Lyme horror stories that long-term problems will inevitably happen to you. And in the case of Anaplasmosis, what I am recovering from just now, there is NO known case of long-term, or chronic, infections. In researching it after I got out of the hospital, I found many of the so-called "Lyme-Aware" websites lumping all tick-borne diseases into the chronic-crisis viewpoint. But deep research into the medical literature at a medical library refutes this. One person who I encountered recently in my effort to get the word out about the presence of Anaplasmosis (someone really promoting the whole chronic-Lyme thing) told me that my high post-disease Anaplasmosis antibody level was "proof" of the disease remained lurking, insufficiently treated, in my body. Um, no, the antibodies show my own system's response to the infection and its state of being able, now, to better defend against it in the future. This is how vaccines work! I suggest taking a good deal of the chronic Lyme online information with a healthy dose of skepticism. Your own primary care doc can take care of you quite well in the case of Lyme. You don't necessarily need to be treated by a so-called Lyme-Literate physician. Do daily tick checks (at least 2X day); decide on some family strategies for minimizing the risk of bringing ticks in on clothing to drop off in the house; consider getting a script for prophylactic doxycycline for tick bites of unknown length; put Frontline on your pets if they go out; get any tick off completely and promptly and without squashing it while doing so; clean the bite with hydrogen peroxide or Betadine; lay in a supply of Benadryl topical cream if you, like me, get very itchy on the third day after a bite; take the 14 or more likely, 30-day, course of treatment if you develop any a tick-borne illness and don't make yourself too crazy over the highly-promoted, but remote, potential of long-term illness. It's not inevitable, nor even, likely. Please note: I am not saying that some people don't develop long-term illness from tick-bites, just pointing out that there is considerable hype, and a lot of misinformation, out there related to Lyme and other tick-borne illnesses. I urge you to keep in mind that most people do not have any serious problems. And I really don't want to dispute Alisande, someone who I respect a great deal. But I don't agree that the treatment protocols are confused. In the case of Lyme and Anaplasmosis, (the only two I have personal experience with)they are pretty straight forward. When my husband was diagnosed with neurological Lyme (a stage worse than "simple" Lyme), I checked out various so-called Lyme-Literate medical practices. Some were so obviously doing "wallet-biopsies" on prospective patients that my alarm bells went off. As Alisande says most won't take conventional insurance or Medicare, require significant up-front cash payments and there's substantial uncertainty whether their treatments are any more effective than standard care. We opted for standard care and even at that advanced stage, it was a complete cure for him. What is very effective against the risk of of all tick-borne diseases is: personal vigilance (daily, careful tick checks); prophylaxis of some bites; and recognition and prompt treatment of any illness. In the case of three of the four possible tick-borne diseases in the NE (Lyme, Anaplasmosis, Erlichiosis and Babeseosis) doxycyline treatments of varying lengths are the cure for the early-stage disease. Only Babesiosis requires different antibiotic regimen. HTH, L....See MoreInduction - cooktop or range?
Comments (13)With you having a new build and not being limited to a tiny existing kitchen, I would give very serious consideration to plllog's suggestions for a cooktop and separate oven. Also, with that design flexibility, I would put the oven at or around counter height rather than under the cooktop and follow plllog's suggestion of pot drawers under the cooktop. Personally, I would find a raised oven much more ergonomic to use. Also, wall ovens these days tend to vent out the front (both oven vapors and the cooling fans for the electronics.) I personally find waist-level front-venting on range ovens and under-counter ovens to be very annoying, although other posters here seem indifferent to it. YMMV. For "Acura versions" of induction cooktops you might want to start with looking into the Bosch 500 series or 800 series 30" induction cooktops and wall ovens or maybe splurge on the Benchmark version with the "flex zone" set-up on the left side. These models have had mostly favorable write-ups here. You can find model numbers on sites like ajmadison.com. If you would prefer an induction range over separates, Bosch has recently released an 800 series induction slide-in (HII8055u) and a Benchmark version (HIIP055u). These and the prior slide-in model (HIIP8054u) have garnered favorable opinions -- if interested you might want to check out the recent thread started by nightflyer and feinmaster about the new Benchmark version which you can find here. The Bosch ranges and cooktops offer 17 or 18 burner power settings and burner controlled timers, which can be real coveniences. If "limited settings" is really your preference, you might look into the Kitchenaid - JennAir induction slide-in ranges (twin versions from Whirlpool with mostly cosmetic differences). Some folks here with those preferences have been pretty pleased with those ranges lthough there have been some less positive experiences. If interested in further researching them, you might want to start by checking out the later posts in this very long thread, this one and this one. Samsung has a couple of interesting slide-in induction models that might be regarded as "Accura" models but not much has been written about them here. The knock on Samsung has been periodic problems with providing warranty, parts and technical support. LG has had a pretty good reputation with its induction cooktops --- IIRC, herringmaven has had one for a dozen years --- but the induction range is too new to have a track record. Toronto Veterinarian has one and posted a good write-up on it, but the search engines are not finding that thread for me right now. (Maybe T.V. knows the link?) Visiting a showroom is a very good idea, especially ones that may have a unit or two hooked up for demo purposes. That may tell you more about how your various choices would or would not work for you. Also, download and read owner's gudes, too. It is always interesting to see what different folks think of house sizes. On my block of old houses, 2800 sq. ft. would be regarded as a large house. Please update us on your search as it progresses....See MoreWelcome basket suggestions for someone I don't know.
Comments (51)Sorry to be away! One fun aspect of small town living is no garbage service, so I’m making a run to the dump today so I spent last night cutting up boxes and loading the truck for the day run. I did offer the guest house out of hospitality. The practice will be reimbursing me for the propane refill as it needed the tank topped off to run the heat and hot water. On a funny side note, there is a pack of hair ties in the bathroom. My daughter or daughter in law left them here. As to the rest of the supplies, they are all there on a regular basis. One of the reasons we bought this place was because of the guest house. I told my husband that if he wanted me to leave Atlanta, I needed to be able to bring Atlanta here, in the form of my friends and family. So I keep the guest house stocked and ready for weekend guests....See MorePill Refill Shortage, Again
Comments (16)Here's pill math of a different kind, no less stupid. I've been taking a med for RLS for over 20 years. My dosage is 1200mg at bedtime. For many years, the prescription called for 4-300mg capsules per day. 120 for a month. One month when I requested a refill, the pharmacy called me the next day and said that my prescription administrator had partially bounced the claim that had been submitted monthly since forever. They were told only 90 pills would be covered per month and that I would have to pay for the remainder of 30 myself. The cost of that was a few hundred $$. I called the administrator and asked why the claim hadn't gone through as before. I was told a cap had been put on individual prescription claims and that no more than 90 of any one drug would be covered per month. I asked if the drug came in a 400 mg size and was told it did. (See how clever I am, knowing that 3x4 is the same total as 4x3). I asked if a prescription for 3-400mg pills would be accepted, to replace the prior approach of 4-300mg ones? Why Yes, it would. Called the doc, got the prescription changed, and have continued taking 1200 mg per day with the same acceptable co-pay to cover. That's been several years now. I dare anyone to try to top that for a ridiculous story....See More- 4 years agolast modified: 4 years agopetalique thanked Zalco/bring back Sophie!
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