Serious QuestionFollow

I'm supposed to go 48 hours with no alcohol for some screening at work. It has nothing to do with my doctor and I. And while the same screening being done again in November will affect my health insurance premium, this one means nothing, other than to tell me how certain blood thingies are.

Should I be a good boy, and not drink tonight, maybe have a beer or two to help me get to bed, or just drink heavily as normal?

Just hold off on alcohol for two days, then get super smashed after the test is done.

Feel free to assume that's the case. To be honest, though, currently I consider smoking to be far worse a habit, and I am struggling with quitting. I think trying to work on both at once will just mean failure for both almost absolutely.

Tylenol PM and caff. free diet pepsi it is for tonight, though.

Daim, do you think the full 48 matters? If it's more like 38-40 is it going to cause huge issues? I had assumed the screening was taking place in the afternoon, but it will be in the morning, and I had a few beers last evening.

Yeah, I don't like to take tylenol normally. It totally forgot to buy a fresh bottle of diphenhydramine, and the store only had tylenol pm.

I'm in medical school. Got a year and a half under my belt, so while I don't have the MD yet, I know most of the scientific aspect of medicine (third and fourth year are all clinical rotations, which just means hands-on experience with all the different specialties and putting the knowledge from first and second year into practice).

It's fine, most people don't know. For that matter, I didn't either until I was actually in it. You don't actually officially choose a specialty until you are applying for residency in your fourth year. Some people know (or have an idea) what they want to do before that, and will take steps towards that early (there are meetings for the different specialties once or twice a month), but most do not know until they get into rotations and actually experience what it's like to be in that particular specialty. You can then use your electives in the fourth year to further focus on what you decide.

I personally have not decided what I want, and will not for at least another year. I've taken a liking to psychiatry in particular lately, but there are other things I have enjoyed in class too. Like I mentioned before, specialties are determined by what residency program you get into, and that's a lot like applying for colleges except far more intense. The tests we take to get our license to practice are called the Step Exams, and I have to take the first one of those (Step 1) in June. I mention this because the grade you get on Step 1 is the single most important factor that determines what progams will accept you. It's like the SAT or ACT, but far more heavily weighted. Most programs won't even accept your application if your Step 1 score is below a certain threshold, regardless of what your grades or extracurriculars are. So I won't truly be able to decide on a specialty until that is done and I know what score I am working with.

Acetaminophen has apparently become the suicide drug of choice around here. I've heard of three people trying to off themselves by ODing on effing tylenol in the last half year or so. One of them almost succeeded.

Diet and exercise will be recommended for the cholesterol and blood pressure (the former is probably being caused by the latter). As far as drugs go, they could put you on a statin (e.g. Lipitor) for the cholesterol, and if that's not enough a diuretic would help your hypertension; they usually don't put you on drugs right away though, because diet and exercise are cheaper and more effective. That will also reduce your BMI, though 27 honestly isn't that bad. It's not uncommon for us to see patients with BMIs of 35-40+. Any family practice doctor would be able to help you with this, though it takes some time for you to see results.

One of the best pieces of diet advice I can give is to cut down on red meat. That's a huge cause of high cholesterol and just switching to white meats like chicken and pork is a (somewhat) easy change that can make a huge difference. We are supposed to recommend ~3-5 meals with red meat per week. Now, I'll go ahead and say that there's no way I will ever do that, as I love red meat too much. But it really does help if you can manage it. I don't know as much about dieting as I should though, so I won't try to give you any more advice about that. I'll let you get help from somebody with more experience.

The hardest thing for me is eating oatmeal in the morning (the texture bothers me, not the taste), and trying to incorporate more beans into my diet.

What's your opinion on Chantix, if I may ask?

And as far as the oatmeal goes, I'm sure there are other options for you. Again, nutrition is not my strong suit, but there are usually plenty of options for getting all the nutrients you need.

That does help, and I do avoid those when I can. (Though I don't try nearly as hard as I should; it's more of a "I'll do this when it's convenient" sort of thing. It's something I need to work on.)

While I'm more of a "hobbyist" level enthusiast as opposed to someone with training, there was a time I became obsessed with nutrition and diet, so I may be able to fill in the gaps.


It has apparently paid off. After weighing myself on a scale that works(the one I'd been using broke because it wasn't made for folks at my weigh), I'm down another twenty pounds. That's a total of fifty.

I believe shirataki noodles are high in soluble fiber(glucomannan, iirc). You can use them as a substitute for other types of noodles, though I really find them to be better in asian dishes than in western ones.