Kevin Nasky DO @psypharmacopeia Twitter profile

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Kevin Nasky DO

@psypharmacopeia

3 years

First recruits reporting to Fort Trump 🤣

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Kevin Nasky DO

@psypharmacopeia

4 years

If you haven't memorized and forgotten the Krebs cycle at least three times, I'm not interested in your opinion on COVID-19, or anything medical, for that matter.

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Kevin Nasky DO

@psypharmacopeia

2 years

@RepGosar I’m a Democrat and an atheist. I served in two branches in two wars. Do I hate America, too? And remind me, where and when did you serve?

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Kevin Nasky DO

@psypharmacopeia

2 years

@ANicholsJDMD Honestly, patient rights have gone a little too far, and when it comes to violence and verbal abuse (I mean, this is flat out hate speech), I think security should toss the patient out into the street. No, I’m not kidding. Healthcare workers have rights, too.

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Kevin Nasky DO

@psypharmacopeia

1 year

1) To prevent my patient from having to undergo multiple pelvic exams. 2) I’m a psychiatrist.

Elle, MD

@elle_gayar

1 year

Why are you consulting OBGYN for vaginal bleeding without doing a pelvic exam? Do you also consult cardiology without listening to the heart?

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Kevin Nasky DO

@psypharmacopeia

6 years

So hospitals want: 1) to be restraint-free 2) have zero falls 3) not pay for 1:1 sitters Somebody help me understand how to do this in a geripsych population.

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Kevin Nasky DO

@psypharmacopeia

2 years

@CalvinLeEasy @latestinspace Humans place a great value on being entertained. It’s silly to complain about how much musicians/actors/athletes get paid because society values it.

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Kevin Nasky DO

@psypharmacopeia

2 years

@dtheavenger @Thom_Hartmann @augie_pup We’re not in denial, or too feckless or weak, but without a true majority (thanks to Manchin/Sinema), we don’t have the votes. Maybe if we pick up seats in November, but we don’t have the votes now.

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Kevin Nasky DO

@psypharmacopeia

2 years

My goal is to move out of this awful MAGA state in the next 12 to 18 months. With the country turning into a dystopian MAGA hellscape, the best I can do is surround myself with like-minded people. So where is a liberal enclave where the cost-of-living isn’t too insane?

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Kevin Nasky DO

@psypharmacopeia

5 years

And after 48 years, I finally have a word that explains why I am overweight.

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Kevin Nasky DO

@psypharmacopeia

6 months

The 5 psych meds I’d hate to practice psychiatry without: 1. Bupropion 2. Lithium 3. Clozapine 4. Mirtazapine 5. Vortioxetine What are yours?

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Kevin Nasky DO

@psypharmacopeia

2 years

@ChrisAlbertoLaw @Ash_Stewart_ @POTUS We’re not trying to “preserve neutrality,” we’re trying to prevent thermonuclear war and the deaths of tens of millions of people.

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Kevin Nasky DO

@psypharmacopeia

1 year

@PA_Stressed_ Because phlebotomy isn’t the role of a physician. I know it’s well-intentioned when a doctor pitches in and helps, but we should all be working at the top of our licenses. If a doc is drawing blood, there’s been a systemic failure somewhere.

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Kevin Nasky DO

@psypharmacopeia

5 years

I hate what weekends do to discharge planning. Discharging a patient on a Saturday evening should be just as easy as discharging someone on a Wednesday afternoon. We need to staff hospitals (and nursing homes) accordingly. Fight me.

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Kevin Nasky DO

@psypharmacopeia

5 years

I wonder what might be causing delirium in an octogenarian who is prescribed tramadol, alprazolam, and a combination medication including butalbital and codeine? 🤔

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Kevin Nasky DO

@psypharmacopeia

3 years

@GuardianUS He’s absolutely right. It should be illegal to bring a semi automatic rifle to a riot. If you say it out loud, it sounds crazy.

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Kevin Nasky DO

@psypharmacopeia

4 years

@JBDerek87 Better than leaving, is staying, protesting, VOTING, and fighting for change. This country can be great. It just isn't yet. 😢

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Kevin Nasky DO

@psypharmacopeia

2 years

@DrGeropsych @KeriCrewsonMD You’re well aware that pain is undertreated in the geri population. Besides round-the-clock Tylenol, what else is available? Many don’t have the kidney fcn for NSAIDs. Tramadol prescribing is universally admonished. Do you just go straight to low dose opioids?

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Kevin Nasky DO

@psypharmacopeia

4 years

If a patient in their 70s develops psychosis following surgery, it’s not new-onset bipolar or schizophrenia. Medical/surgical colleagues, I love y’all, but you can do better than this. You guys should be able to spot postoperative delirium from across a room.

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Kevin Nasky DO

@psypharmacopeia

2 years

@MayoIsSpicyy Uh, no, she’s not. Unless the justice department acts (they haven’t, and they won’t), these hearings are nothing but a television show.

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Kevin Nasky DO

@psypharmacopeia

2 years

@e_welchcarre @SaltyLikeSaline Families can be awful, and feeling constantly unappreciated by them is a more than valid reason to want to quit.

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Kevin Nasky DO

@psypharmacopeia

4 years

@AZGOP Wait, hold up ... you mean to tell me that holding unofficial “hearings” in midrate hotel conference rooms is having no effect on Biden’s landslide victory? 🤣

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Kevin Nasky DO

@psypharmacopeia

3 years

@JarJarFan69 @BrandyLJensen Meal Team Six reporting for duty, SIR!

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Kevin Nasky DO

@psypharmacopeia

5 years

Pro Tip: If a patient comes to you from a nursing home diagnosed with "Bipolar and Schizophrenia," rest assured the patient likely has neither.

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Kevin Nasky DO

@psypharmacopeia

3 years

@unscriptedmike

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Kevin Nasky DO

@psypharmacopeia

2 years

@librarycongress @lizzo This is awesome. This is an instrument, it’s meant to be played. This is a way better way to appreciate this piece of history than looking at it behind plexiglass.

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Kevin Nasky DO

@psypharmacopeia

2 years

I don’t think I’ve ever seen a better representation of nighttime rumination.

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Kevin Nasky DO

@psypharmacopeia

2 years

@garyresists @joncoopertweets Here’s the thing … we don’t get to define “their best interests.” That’s a losing strategy. If we want to win any of these voters back, we need to quit telling them what’s important to them, and listen instead.

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Kevin Nasky DO

@psypharmacopeia

2 years

@WreckaCenter @OleoWildlion @AkilahObviously Please cite source that milk causes anxiety.

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Kevin Nasky DO

@psypharmacopeia

3 years

I’ve been in a funk. Life stuff, maybe some depression. It’s been a rough year or so. Big step today: I ran. Very slowly. But I ran, and more importantly it felt like I flipped a switch mentally. Ready to commit to taking care of myself again. Making it a priority.

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Kevin Nasky DO

@psypharmacopeia

2 years

@Variety I adore Bryce Dallas Howard, but he’s a much bigger box office draw than her. I’m not saying this industry probably can’t do a better job of pay equity, but these two really aren’t in the same tier when it comes to star status, right?

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Kevin Nasky DO

@psypharmacopeia

3 years

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Kevin Nasky DO

@psypharmacopeia

5 years

Lost my dad yesterday, somewhat unexpectedly. He had dementia (bvFTD, specifically), but otherwise healthy. He lived on a locked “memory care” unit. He actually died in a geripsych hospital — his 4th such hospitalization. I haven’t even begin to process/unpack all this yet 😢

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Kevin Nasky DO

@psypharmacopeia

2 months

@AshleyGWinter Hyperbaric oxygen has been a solution, looking for a problem for as long as I can remember.

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Kevin Nasky DO

@psypharmacopeia

3 years

Landlord just abruptly told us homeowners want to sell the house we’re renting, and have given us five weeks to vacate. We are a family of 6 (+2 dogs). There’s not much out there in the rental market. I am officially freaking out.

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Kevin Nasky DO

@psypharmacopeia

2 years

@RiviereTosh Sadly, a lot psychiatrists (dare I say a majority?) are skeptical (or outright distristful) of any adult with an ADHD chief complaint. A lot of them presuppose “if you weren’t diagnosed as a child then you must be trying to scam stimulants.”

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Kevin Nasky DO

@psypharmacopeia

2 months

@epollaert I don’t know a single doctor who works 9 to 4, and I know lots of doctors.

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Kevin Nasky DO

@psypharmacopeia

2 years

@kdqd3 @ejeancarroll 55% of white women voted for Trump. All the math in the world doesn’t change that fact.

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Kevin Nasky DO

@psypharmacopeia

2 months

The most Christian friends I have are actually swingers. No shit. Church on Sunday, but Saturday night they’re at swingers parties. Meanwhile, me and my wife, both atheists, are at home with our children, watching our dumb tv shows. 1/2

SG

@antitheistdad

2 months

I find it very disturbing that Christians still seem to believe that you can't be moral without a belief in god. How are we still stuck in this antiquated thinking? We've grown up as a species, we no longer need a god to understand how we should treat other people.

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Kevin Nasky DO

@psypharmacopeia

5 years

Any physicians here feeling burned out? Worry not! Management is diligently working on adding mandatory Mindfulness courses to your Healthstream account!

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Kevin Nasky DO

@psypharmacopeia

2 years

@sweetchinchilla How is this even still a thing? I swear 90% of middle management just needs to disappear.

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Kevin Nasky DO

@psypharmacopeia

4 years

@ccardyDNP The only people I expect to call me "doctor" are my patients. Outside of that, just call me by my first name. I know I'm a doctor - I don't need students and residents to remind me of my title.

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Kevin Nasky DO

@psypharmacopeia

2 years

@ZaleskiLuke @elonmusk All the things he could do with his money and platform … and he chose to be the world’s biggest troll.

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Kevin Nasky DO

@psypharmacopeia

5 years

For the 8000th time, a patient wanting to get out of bed and walk is not a reason for geripsych admission. The solution is to let them walk, and afford them whatever assistance is required in order to walk safely.

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Kevin Nasky DO

@psypharmacopeia

4 years

@maddow Saying a DO specializes in osteopathic medicine is like saying an MD specializes in allopathic medicine. The MD/DO degree is the general medical degree. Speciality is determined by residency & board cert. In this case, his “speciality” is Emergency Medicine.

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Kevin Nasky DO

@psypharmacopeia

2 years

@PastorJohnHagee Marriage is a legal contract. Your god need not “recognize” it.

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Kevin Nasky DO

@psypharmacopeia

5 years

Just saw a psychiatrist say he avoids trazodone in the elderly because of its anticholingeric burden so I thought I'd do this little PSA: TRAZODONE IS NOT ANTICHOLINERGIC. Not even a little. Here's a great figure that illustrates how NOT anticholingergic trazodone is.

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Kevin Nasky DO

@psypharmacopeia

2 years

@Jessicam6946 I’m generally opposed to the death penalty, but this gives me pause. There’s a hell of an argument for exterminating that life.

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Kevin Nasky DO

@psypharmacopeia

1 year

@covie_93 I’m still partial to Captain Bonespurs

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Kevin Nasky DO

@psypharmacopeia

2 years

@AdamParkhomenko I’ve read a tweet like this at least once per day for the past year or so. So far, nobody in power has gone “through some things.” Not one.

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Kevin Nasky DO

@psypharmacopeia

1 month

@calling_ma65369 @wasphyxiation Crime is WAY down since the 80s. We live in the safest time in human history.

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Kevin Nasky DO

@psypharmacopeia

2 years

@Regular_Doc Well, if you needed confirmation that it was the right move …

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Kevin Nasky DO

@psypharmacopeia

3 years

@paulsperry_ This should be fun. 1. Trump is wrong. There’s no constitutional right to social media. 2. I have a feeling FB and Twitter have better legal counsel than the Trump.

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Kevin Nasky DO

@psypharmacopeia

1 year

@drraja_ Feel free to steal/borrow. I use this as a teaching aid.

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Kevin Nasky DO

@psypharmacopeia

3 years

@yashar Psychiatrist here. I have never seen a case were someone was appointed a conservator/guardian unless they met one of these three criteria: 1. Schizophrenia/schizoaffective D/O 2. Severe intellectual disability 3. Severe dementia

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Kevin Nasky DO

@psypharmacopeia

5 years

Pls send good vibes. A pneumonia I had last month is now an parapneumonic effusion. Thoracentesis only got out 400mL of exudate, but pulm says CT showing 1500mL. Getting a chest tube today. If that doesn't work, sugery (VAT vs open pleural decortication).

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Kevin Nasky DO

@psypharmacopeia

2 years

@allicovington This is great! Join me on inpatient rounds tomorrow and help me figure out which exercises will treat a schizophrenia relapse.

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Kevin Nasky DO

@psypharmacopeia

2 years

@dremilyportermd @WFKARS Did y’all not have a picture like this in your health class book?

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Kevin Nasky DO

@psypharmacopeia

2 years

@adamkotsko Rural? What about suburbs? I live 20 miles from my job? And how do we get 4 kids to and from soccer, music lessons, doctors appointments … how do we all go out to dinner … how do we run errands all over town? On busses? Are you high right now?

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Kevin Nasky DO

@psypharmacopeia

2 years

@Bubblebathgirl I don’t care what his name is. We need to do what Australia did and make guns nearly impossible to get. Yeah, that means amending the constitution (we’ve done it before).

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Kevin Nasky DO

@psypharmacopeia

1 year

#MedTwitter with all the fretting over "reports," "complains of," "endorses", "admits/denies" ... why don't we just write: "The patient *tells* me he has been experiencing ..." Seriously, what's wrong with tells/told? Or for that matter, says/said?

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Kevin Nasky DO

@psypharmacopeia

4 years

I’m going cite “abundance of caution” the next time an insurance reviewer wants to deny one of my weak admissions!

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Kevin Nasky DO

@psypharmacopeia

2 years

@JRMajewski Hey remember that one time you said you served in Afghanistan, and you didn’t? Sincerely, Someone who served in Afghanistan

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Kevin Nasky DO

@psypharmacopeia

3 years

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Kevin Nasky DO

@psypharmacopeia

5 years

Love psych, but everybody has an opinion about virtually all aspects of psychiatry. Sometime I daydream about being a nephrologist, because random-ass people don’t have strong opinions about how to treat RTA.

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Kevin Nasky DO

@psypharmacopeia

2 years

@DonChaney2 @RonFilipkowski She has a 4-year degree from The Citadel and Masters Degree from the University of Georgia. I don’t like her politics either, but let’s not straight up lie about her.

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Kevin Nasky DO

@psypharmacopeia

5 years

How do I educate an entire community on safe prescribing in the elderly? Seriously, some of these patient medication lists looks similar to the actual BEERS list. How about a geriatric pt on the following for fibromyalgia? Oxycodone 40 mg qd, Klonopin 2 mg qd, Elavil & Lyrica.

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Kevin Nasky DO

@psypharmacopeia

2 years

@bruceburdock @Lekelitt @ninaturner Because many professions that are crucial to society are grossly underpaid (e.g. teachers, social workers, etc).

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Kevin Nasky DO

@psypharmacopeia

1 year

@Dr_mac2 They can’t get an outpatient appt, and they know 4am has a shorter wait time.

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Kevin Nasky DO

@psypharmacopeia

5 years

If I were king, geripsych units would provide: - thoughtful prescribing & #deprescribing , guided by collaboration of psychiatrist, geriatrician & pharmacist - optometry & audiology assessment (let’s optimize sensory input!) - neuropsych testing for dx clarity - PT/OT assessment

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Kevin Nasky DO

@psypharmacopeia

2 months

@MarkLRuffalo Aw thanks. Check is in the mail!

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Kevin Nasky DO

@psypharmacopeia

2 years

@lavern_spicer You may want to look into this, and recall something in high school civics… I actually don’t think rally attendance has anything to do with how we elect the Presidents. 🤷🏼‍♂️

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Kevin Nasky DO

@psypharmacopeia

2 years

@JDCocchiarella I’ve seen some version of this “somebody’s about to go through some stuff!” tweet about 1000 times in the past few years. And then no one ever goes through stuff.

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Kevin Nasky DO

@psypharmacopeia

2 years

@MrAndyNgo @WanderLinger @robbystarbuck Im a democrat and this is a straw man. Apparently someone took their kid to a drag show. What does that have to do with politics? I’m not aware of any Democratic policy that promotes this, are you?

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Kevin Nasky DO

@psypharmacopeia

5 years

@emily_fri Because our software isn’t designed for its users. It’s designed, by committee, the the specifications of people who don’t use it (administrators). The people who buy it aren’t the people who use it. That’s why it sucks.

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Kevin Nasky DO

@psypharmacopeia

2 years

@RyanMarino @mirandayaver

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Kevin Nasky DO

@psypharmacopeia

2 years

@costareports This flirtations with avowed far right racists are a feature not a bug. Carefully calculated. It’s a wink-wink to their deplorable base while maintaining plausible deniability.

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Kevin Nasky DO

@psypharmacopeia

4 years

@ziwe How do you tackle racism without discussing it?

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Kevin Nasky DO

@psypharmacopeia

3 years

Any ideas for non-stigmatizing language to describe when a patient procures opioids or other prescription drugs that aren’t prescribed to them? Off the street” is stigmatizing and also likely quite inaccurate as a descriptor. “Illegally” is stigmatizing, too. 🤷🏼‍♂️

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Kevin Nasky DO

@psypharmacopeia

1 month

@sassistheword I know exactly what’s in my bag because I packed it. It’s called being a responsible adult. I’m also not an ammo-sexual so there’s 0% chance I’m going to randomly have a few extra rounds in my luggage.

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Kevin Nasky DO

@psypharmacopeia

5 years

I’ve read a bunch of papers this week about palliative care in advance dementia and I’m, at once, energized and downtrodden. The direction we need to go into is clear, yet regulatory agencies aren’t on board. 😪

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Kevin Nasky DO

@psypharmacopeia

4 years

"Difficult" family members are often anxious. My early career mistake was to avoid them. Now I initiate conversations early and err on the side of over-communication thereafter. E.g. "Is there anything I can do today to help you feel more comfortable about your mother's care?"

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Kevin Nasky DO

@psypharmacopeia

1 year

@viviendoama Psych here: When I do med floor consults, I always kick the families out of the room. Families bristle but that’s okay. I can always (with patient’s permission) talk to families later if needed. (Not to mention, patients often aren’t as forthcoming if family is present).

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Kevin Nasky DO

@psypharmacopeia

5 years

1/x For the love of all that's holy, can we stop conflating the treatment of delirium with pharmacological interventions we use stop the behavioral manifestations of hyperactive delirium? They're not the same thing. I treat delirium by finding any treating any/all reversible...

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Kevin Nasky DO

@psypharmacopeia

2 years

@sydneyesbrown When you get to a point where you’re faster, and you start having days where you purposefully run at slower paces (an “easy day”), you won’t dread every run. I think when you can start staggering intensity and duration, there’s some variety, then not every run is a ball buster.

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Kevin Nasky DO

@psypharmacopeia

3 years

@JackPosobiec Good! Fracking poisons groundwater, pollutes surface water, impairs wild landscapes, and threatens wildlife. We need to focus on renewable energy!

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Kevin Nasky DO

@psypharmacopeia

1 year

@DGlaucomflecken

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Kevin Nasky DO

@psypharmacopeia

5 years

Just a reminder...if you’re working this weekend and run across an elderly patient with paranoia...before you start writing “schiz....” ✋ STOP 🛑 and remember that paranoia is often “the last gasp of a failing mind” — think dementia +/- delirium.

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Kevin Nasky DO

@psypharmacopeia

2 years

The two most challenging behavioral manifestations of advanced dementia that often don't have a good solution. 🧵 1/10

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Kevin Nasky DO

@psypharmacopeia

2 years

@d_a_swafford @RiviereTosh I can’t tell you how many patients I’ve had who’ve had their lives completely changed after getting diagnosed and treated for ADHD as an adult.

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Kevin Nasky DO

@psypharmacopeia

3 years

@xielody4 In this med student’s defense, he or she doesn’t have the context of any clinical experience to know what to value vs. devalue. The student’s mistake here is posting such a strong opinion about a curriculum that he/she has no possible way to have an informed option of.

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Kevin Nasky DO

@psypharmacopeia

1 year

At first, I thought it was paranoia, but Twitter has changed. I’m not only seeing qrazy ultra MAGA posts more often, I’m seeing posts from far right accounts that I’ve muted. I guess I have to start straight up blocking accounts to not see their hateful drivel?

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Kevin Nasky DO

@psypharmacopeia

6 years

Know your toxidromes!

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Kevin Nasky DO

@psypharmacopeia

2 months

@DickMcgirr I got a few hours, interrupted by a few nurses’ phone calls.

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Kevin Nasky DO

@psypharmacopeia

2 years

@Dallas_Holladay I look at this the other way, and am reassured. Seriously, if my “smart” dryer doesn’t know the difference between wet and dry, we’re probably still a few hundred years away from the singularity 😂

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Kevin Nasky DO

@psypharmacopeia

2 years

@morrispexmouth @LeghamLemming You’re not familiar with what the advanced stages looks like (most people aren’t — it’s hidden from the public pretty well).

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Kevin Nasky DO

@psypharmacopeia

4 years

Alright #medtwitter : Reversible Dementia vs Dementia with Delirium vs Dementia with behavioral disturbances Let’s explore. #tweetorial 1/

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Kevin Nasky DO

@psypharmacopeia

7 years

@kellyblaus The phrase "friend zone" exists because "I have a friend whom I have unreciprocated romantic feelings for " is a mouthful.

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Kevin Nasky DO

@psypharmacopeia

2 years

@joncoopertweets Why are so many in the GOP so vocally defending him? It’s bordering on fealty at this point. Self-preservation is an instinct most people have so I don’t get why people are literally jumping onto a sinking ship. Wouldn’t this be the time to lay low and see how things shake out?

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Kevin Nasky DO

@psypharmacopeia

2 years

@RandyEls1 @TanyaKeith Do you really believe the first amendment has anything to do with this? The first amendment guarantees the government can’t silence speech of its citizens. It has nothing to do with employers and employees.

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