I'm wondering what the alternative to metronidazole is, though. It's not the most benign antibiotic, and some people don't tolerate it very well. The options are topical clinda or topical metronidazole for women who don't want to do systemic treatment.. what's the alternative to PO flagyl in men? Slathering up with the clinda cream?

Several years ago I had a pretty miserable time on metronidazole for BV. I only took three days, I think, but ended up with severe anxiety, an elevated heart rate, weird brain fog, horrible headaches, and vision changes that lasted 3ish months.

It's quite rare, but some people have an awful time with metronidazole--and psychiatric side effects are frequently reported in those uncommon side effects. It's also neurotoxic for some people (that warning about paresthesia/tingling in hands and feet). If you're noticing unpleasant side effects, stop the medication, and see your doctor.

You can always use metrogel as another poster had said, or clindamycin 2% topical vaginal cream (which I've had decent luck with).

The oral B pro clean 5000 has a little sensor that tells you when to move to a new mouth quadrant. So you get 30s per quadrant, and then it buzzes, and you go on to the next quadrant. At the two min mark, it buzzes four times, but keeps going, so you can finish up any bits you hadn't done, or your tongue, etc. Worth the $75, honestly.

The text revision (-TR) is not actually a new publication. It has a total of one new entry, prolonged grief disorder, and a couple of notes were cleared up, but as regards personality disorders and the vast majority of entries, the DSM-5 is still in active use. I guess that's why all my supervising psychiatrists on my psychiatry rotation last winter still have their copies. Incidentally, the entry re NPD remains entirely unchanged, so I'm not sure what point you're trying to make?

The NPD entry, under "diagnostic features" starts out with “The essential feature of narcissistic personality disorder is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts.”

And as regards criterion 7,

“Individuals with narcissistic personality disorder generally have a lack of empathy and have difficulty recognizing the desires, subjective experiences, and feelings of others (Criterion 7). They may assume that others are totally concerned about their welfare. They tend to discuss their own concerns in inappropriate and lengthy detail, while failing to recognize that others also have feelings and needs. They are often contemptuous and impatient with others who talk about their own problems and concerns..." and it goes on.

You can argue diagnostic criteria all you like, but dude above is pretty clear, and you're the one with the funny ideas about how he's conflating psychopathy with NPD. Hilariously enough, psychopathy isn't actually a diagnosis in the DSM.

https://www.ncbi.nlm.nih.gov/books/NBK556001/

Nope. The person to whom you're replying is absolutely correct that lack of empathy is a hallmark of narcissistic personality disorder. I've linked the Statpearls entry for NPD for you - it includes the current DSM-V diagnostic criteria.

If all the suggestions for more foreplay don't work out, she could try talking to her doctor about potentially having vaginismus, and any benefit of pelvic floor physiotherapy.

Like many others, I can't visualize very well. I always thought that imagery in poetry was a conceit, not that people could actually see the things.

Also, I have never had an icecream headache, cannot smell asparagus pee, can't taste Bitrex (bitterant for mask fittings), and did not know it wasn't normal to have pain at the vaginal opening with sex (after all, all the romance novels made out that sex hurt the first time, but mine just never got better).

I made a comment elsewhere about this recently, but OMG, this guy.

Tinder date with a 52 year old optometrist. Within 3 minutes of sitting down to dinner he opened with "what's your worst date ever," and I told him that I have a few stories, and then asked him to tell me his first.

Well, turned out he'd recently matched with a 27 year old, had three dates and a sleepover, and then she had the gall to tell him that she needed new tires for her car. So he ghosted her, he tells me, because she was "a gold digger." I'm immediately turned off, because, ew, 52 years old and going after 27 year old girls. Also, proudly telling me that he ghosted her. And really, buddy is a 52 year old optometrist with a receding hairline, not a neurosurgeon--how did he really think this was going to play out? She wasn't dating him for his sparkling personality and charm.

But then he really gets warmed up, and spends the next twenty minutes regaling me with how he'd just gotten in trouble at work for sexual harassment of a 20-something female colleague. He really belaboured the point that it wasn't sexual harassment, because he knows what sexual harassment is, and he has in fact taken management-level workplace training courses about what constitutes sexual harassment which is, just in case I don't know, "unwanted comments or contact" (and at this point, I'm like, my guy, are you really mansplaining the definition of sexual harassment to your 45F date and believe me I know what sexual harassment is a whole lot better than you do), because, according to him, it wasn't unwanted contact. And then he whined about how, in today's environment, you just can't say anything to anyone anymore without someone getting offended, and was feeling really quite sorry for himself, and expecting me to sympathize.

I could feel my face getting more and more blank, and eventually I just pushed my half-finished plate back and told him it had been interesting to meet him, but I had other things I had to do. I stood up while he was gaping at me, put my jacket on, walked to the cash, paid my half for dinner, went out to the parking lot, and drove away.

I cannot imagine, for the life of me, why he thought this was appropriate first date conversation. I am still WTF, and this is, for the record, the only date I have ever walked out on.

I'm so glad I get to share this story. Even if it's far too late for the thread, and no one else reads it.

I (45F) went on a date last year with a 52 year old male optometrist. He started off the date by telling me about how his last date (27F) went out on three dates with him, they then spent the night together, and he ghosted her after she told him that her car needed new tires, because she was "a total gold digger". He then spent the rest of the dinner date telling me that he'd been accused of sexual harassment at work, but that it wasn't sexual harassment because he has taken work training courses on sexual harassment, and this was not that. Specifically, he'd made an off-colour remark that he felt was misinterpreted.

I just told him that it had been interesting to meet him, and that I would be paying my share of the bill, and that I was no longer hungry and had other things to do. I grabbed my jacket and my purse, stood up from the table while he was gaping at me, paid my half, and left the restaurant.

I've been on some bad dates, but holy fuck, why would you lead with a story about being accused of workplace sexual harassment on a first date with a woman that you didn't know. Way to make an impression, buddy.

you can't effectively palpate the canal and feel for masses with your thumb, and if you're in there on a fellow, you're going to have a quick feel for a prostate anyway. So, incorrect. Anytime a health pro puts a digit up a rectum, it's a finger, def not a thumb. Source: have been formally trained and practiced far too many DREs (digital rectal exams) for rectal bleeding/hematochezia/melena/lumps, etc.

At a guess you have a yeast infection, and you have hymenal tags or remnants that are irritated and swollen with the infection. Alternatively, could be condyloma (warts). See a doctor for peace of mind, friend.

Na fam, it's literally just liquid left in the rectal vault. Distension stimulates rectal vault mechanoreceptors, triggering the rectoanal inhibitory reflex whereby a small amount of feces is then passed into the anal canal and the body decides what kind of material is in the rectum (eg, gas, formed stool, liquid stool). Then skeletal muscle of the external sphincter (under voluntary control, as compared to the inner anal sphincter which is involuntary) can relax in combo with valsalva to allow passage.

Basically, through the rectoanal inhibitory reflex and "sampling" the body is like "Oh, this is liquid. Must be diarrhea. Let's have liquid shits!"

(Student) on my first call shifts for IM I deliberately chose THE MOST IRRITATING ringtone and notification sounds I could find in my phone so that I would be enraged enough to not sleep through it.

For the record, in medicine, and especially in the context of mental health, PDs are not "exotic" pathologies, and are unpleasantly common. The DSM-5 reports that borderline personality disorder, for instance, has a prevalence of ~6% in general practice, rising to 10-20% in psychiatric medicine contexts.

We diagnose PD when personality traits impair people's abilities to live a reasonably normal life (impacting work, family, social spheres, etc). Otherwise, it's just personality traits--we all have them, to one degree, or another.

Dude, this ain't a hook up sub. You wanna get sexy in PMs, use another sub, please and thank you.

Nope! Vivitrol is Naltrexone, a slightly different opioid antagonist with a much longer half life than Naloxone.

Given how often rhabdo happens to experienced cross-fitters, and the numbers of injuries cross-fit brings to the ED, it seems like people actually don't know where their limits are. This suggests that maaaaaaybeeee it's actually hard to tell, and the Cross-Fit philosophy encourages people to push past every limit they've ever felt.

A patient's family member tried to sneak past the nursing station with a bag for the patient. The bag included:

​

Black nitrile gloves

zip ties

binoculars

a hunting knife

duct tape

​

...the staff were understandably upset.

What about the huge collection of teddy bears, nightlights, favourite blanky/pillow, portable makeup station (including mirror, blowdryer, haircurlers), and all the other move-in gear?

Photo missing. Post removed.

No photo! Please resubmit with a photo. Thank you!

Nope. Nonsexual sub. Post removed.

You're cute, you look great, and I can see the bottom of what looks like a very nice beard. Sorry your day sucked, and hope it gets better!

You look terrific! Good job you :)

Everything you got going on looks terrific. You're very handsome!