The ETR 600 is a class of trains built by Alstom, and are used on the routes between Roma-Bolzano and Roma-Trieste. The train tilts, using Pendolino technology, allowing higher speeds to be maintained through corners without causing discomfort to passengers. The trains are operated by Trenitalia, originally under the Frecciargento (Silver Arrow) branding used for trains capable of travelling between 250 km/h and 285 km/h, In 2022 they were rebranded under Frecciarossa (Red Arrow) after the Frecciargento branding was retired.
The ETR 600 has also been adapted for use in China as the China Railway CRH5 Hexie. Initially 60 sets were ordered, of which nine were manufactured by Alstom and 51 by CNR Changchun Railway Vehicles. Since, another 80 sets have been created for a total of 140, operating across China's north from Beijing to Ürümqi.
Join our public Matrix server! https://matrix.to/#/#tracha:chapo.chat
As a reminder, be sure to properly give content warnings and put sensitive subjects behind proper spoiler tags. It's for the mental health of not just your comrades, but yourself as well.
Here is a screenshot of where to find the spoiler button.
Had two medical appointments today and both predictably asked for a list of prescriptions I'm taking. Decided to list E and spiro for both (usually I haven't)... both times the only prescription either nurse asked about was the E/spiro (and for the second one, I just listed off like 6 other prescriptions, perhaps mispronouncing some of them and never was even asked to repeat any of them).
The spiro, I can understand given its also used as a bloodpressure med and a diruetic. How many other uses are the for E in people with a "Sex: M" on their medical chart?
Sometimes we have to ask you because patients legit don't know why they're on what they're on and it leads to polypharmacy and bad interactions. "Oh, that's my antihypertensive it's to make me less hyper!" No, honey, it's to make your blood pressure lower.
And sometimes, bless them, my fellow nurses aren't all that much smarter than patients to my eternal chagrin 😭. That may have been the first time they ever encountered a trans person on HRT, if they don't see the med every day they won't necessarily know about it. I'm lucky, I usually only need one or two encounters with a med to learn about it off-hand for the future - doctors are some kind of memorization freaks way above that level lol
Anyway, taking the best possible medical history (BMPH) is a standard nursing task and it's standard intake, they'll ask every time. Patients aren't always the best historians on what they're taking so we will keep asking you. You sound like you have a good grip on stuff, but I don't know how many times I've encountered people who when I access their online med profile they forgot to tell me they're a diabetic and they take metformin or basaglar 😑
Makes sense. I've certainly forgotten to mention things before. Like, one time I forgot to mention sleep apnea because I was just at the ER for a broken wrist. Expected a couple of x-rays, a sling, an a referral to see an orthopedic surgeon on a weekday, and to be on my way so it just didn't come to mind; I don't think of a cpap as a prescription. Until they were talking about putting me on general anesthesia, so brought it up (without prompting). They switched to ketamine based on that info, so I managed to get out of unnecessarily being put all the way under and got an interesting experience for someone who doesn't really recreationally use drugs. But I scale how much I reveal based on what I deem relevant. But potentially starting a significant new medicine means I'm much more likely to give as much info as possible: even if it were to including admitting to taking something illegally.
I had to re-read that a couple times because I was like "Wouldn't anti-hypertensive just mean the same thing as lowering your blood pressure? How were they wrong?" until I finally stopped glossing over the "make me less hyper" part. Pretty impressive level of misunderstanding of their own medications.
Perhaps. Pretty much all my other medicines were related to the medical conditions I have listed on my chart (which was the thing I was seeing a doctor for in the first appointment), so I can see why they'd be confused at first. Also my hesitation with mentioning the HRT might also bring more attention to it on accident. I did mention I haven't had a consistent pharmacy at the first appointment, so that might have been a red flag too.
i'm a bad person, i don't typically tell anyone that doesn't like really need to know since i don't want to have that conversation, tbh
I don't think that's bad. In this case, I thought it might have been semi-relevant for one of them and didn't want to hide that before starting a new medication (also an injection). In the second case, it was a virtual appointment with someone with my insurance company to get a gift card... so like they're already paying for it, so not really any point in hiding it. But like... I'm not gonna mention it at the dentist or an annual checkup.