FlexNP @rn_flex Twitter profile

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FlexNP

@rn_flex

5 months

Clinical trial update for retatrutide. It's been 5 months. I had confirmed non-alcoholic fatty liver disease(NAFLD) when I started the trial. I had a CT scan this week of my abdomen. Liver is completely normal. No fatty liver. It's just gone. Oh and down 23.5% body weight (56lb)

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FlexNP

@rn_flex

7 months

I'm in a weight loss trial for the drug retatrutide a triple hormone agonist Some quick notes: Total Cholesterol ⬇️ 24.5% LDL ⬇️ 21% VLDL ⬇️54% Triglycerides ⬇️ 48% Weight ⬇️ 24lbs Triglycerides & total cholesterol are now normal. LDL is 1 point above normal...In NINE WEEKS.

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@rn_flex

1 year

If the hospital therapy dog greets you as walk in the door for your shift does that mean the day is gonna be great?

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@rn_flex

2 years

@janecoaston @Popehat Don't they know that soy products are out and oatmilk is all the rage now?

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FlexNP

@rn_flex

5 months

@TraumaSoapBoxes When you hear the screaming of the parents, it never leaves your soul. Make the damn madness stop.

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes Little biochem/pharm meme

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FlexNP

@rn_flex

7 months

I passed my FNP boards today!!!!!! Ahhhhhhhhhh

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FlexNP

@rn_flex

5 months

@BassoonYsu Right? I mean I'm in disbelief at how fast it happened. A disease with no FDA approved treatment is just gone in 5 months. All lipids and cholesterol levels have plummeted, my systolic BP is down ~15 points diastolic down ~8. Just crazy numbers across the board

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FlexNP

@rn_flex

6 months

112 days in clinical trial for retatrutide. Weight ⬇️45.2lbs Triglycerides was 255mg/dl, now 102mg/dl ⬇️60% Total Cholesterol ⬇️ 22% was 245mg/dl, now 192mg/dl VLDL ⬇️ 52% LDL ⬇️ 20% Liver enzymes have normalized. Miracle. Drug.

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FlexNP

@rn_flex

1 year

I hate that this is the correct answer. I hate that practice board questions are making people think it's ok to just order a UDS without thinking about the downstream consequences for the patient, especially for a patient who is technically still a minor

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes And dying for a multiplicity of reasons. Poor morale. Inexperienced staff. Not enough staff. Sicker patients. Boarding. Lack of resources and on and on

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FlexNP

@rn_flex

1 year

@DGlaucomflecken Literally heard EM consult nephrology the other day on the phone EM: Yup sodium is 118 Short Pause EM: No I didn't give a bolus or serum osmolality...well can you just...can you....please...well see I didn't think to order....oh ok I'll call you back

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FlexNP

@rn_flex

1 year

@hankgreen The rotavirus vaccine hasn't even been out for a generation and yet it's drastically reduced infant mortality from diarrhea (estimates are it prevents 225,000 deaths per YEAR) Med and nursing schools teach it like it's always been there despite only becoming available in 2006

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FlexNP

@rn_flex

7 months

@HollyAnderson Hell of an overnight build. Kid is gonna go wild for it

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FlexNP

@rn_flex

7 months

Theme of the night is pecans and bourbon. AND CELEBRATION!! I'M DONE WITH MY FNP PROGRAM!! I MADE IT!!!!

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FlexNP

@rn_flex

5 months

@HachezYanicka Yes very similar but it works on three hormones. Glp-1, GIP and Glucagon and that has a synergistic effect on weight and a lot of other things. And yes it's very anti inflammatory for me as well. I used to have chronic Achilles tendonitis. It's gone now too.

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FlexNP

@rn_flex

7 months

Literally miraculous. I'm not even done with the dose escalation phase. Just no words for what has happened to me in just 9 weeks. The weight loss is amazing, but the improvements in my lipids is literally UNREAL. Holy shit. And I'm in this trial for another 17 months 🤯

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes When I used to be trauma manager one of the SICU nurses sent me this 💀

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FlexNP

@rn_flex

2 years

@EM_RESUS Multi GSW with tension hemopneumothorax on the left?

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FlexNP

@rn_flex

7 months

@gary_teroller Because I've tried for years to lose weight with diet, exercise and everything else you can imagine. Nothing ever worked. And no offense but that's an outdated concept. Obesity is recognized as a disease of dysregulated metabolism for most people. It's ok to use drugs to treat it

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes 🫠🫠🥴🥴

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FlexNP

@rn_flex

1 year

@crabby30somthng Can you get it filled without insurance? Make grocery stores and big pharmacies zofran is pretty cheap

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FlexNP

@rn_flex

2 years

@Bry_Mac Put another way. Tell me you've never watched a Michigan football game this year without telling me you haven't watched a Michigan football game this year.

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FlexNP

@rn_flex

2 years

@HollyAnderson On the lookout for the reindeer who were in her domain last night

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes @DGlaucomflecken special right here

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes Last week called for respiratory distress. Pulse ox 98%. Respiratory rate: FORTY TWO. Pulse ox is a liar. The end.

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FlexNP

@rn_flex

2 years

@MortytheRN @TraumaSoapBoxes What's the best way to start a Saturday off right? Creme brulee donut.

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FlexNP

@rn_flex

5 months

@ProdigalHoosier Luck. I was interviewing an obesity researcher for my masters thesis on GLP-1 drugs and they mentioned I should enroll because of my weight and NAFLD....and I qualified and got in!

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FlexNP

@rn_flex

1 year

@RyanMarino I wore a suit like that when we were practicing a hazmat scenario cleanup of a chlorine gas or anhydrous ammonia spill. Cuz both of those compounds will kill you dead real quick and are actually dangerous when openly airborne

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FlexNP

@rn_flex

2 years

@traumaadventure Some days it feels like we're responsible for figuring out the world's problems every shift. I don't mean to be negative but it is so so exhausting

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FlexNP

@rn_flex

5 months

@bendreyfuss @nycsouthpaw And Ozempic is the start. I'm in a trial for a new GLP-1 drug called retatrutide. It induces more weight loss and has *better* metabolic benefits than Ozempic. The revolution is just getting started. I'm down 51 lbs in 5 months and my cholesterol and lipids are now normal levels

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes What causes your lactate to high? Hospital: SEPSIS SEPSIS SEPSIS Me: Well actually I have this great chart and it's only occasionally sepsis Hospital: SEPSIS WE MUST MEET OUR METRICS

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FlexNP

@rn_flex

1 year

In the continuing annals of urine drug screens are worthless, I've now seen a 98 year old get drug screened because they took tramadol for a spine fracture. What the hell are we doing folks. 🤦‍♂️

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes Meanwhile, when I did actual research on a project like this for grad school, the biggest factor for increasing resilience and retention was actually retraining how managers and directors acted and treated their staff. Shocking, I know.

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes Also, keep in mind a blood pressure of 110/60 if your patient is over the age of 65 is probably hypotensive, especially in an emergency room setting!!

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FlexNP

@rn_flex

8 months

@TraumaSoapBoxes Shoot I've seen ground level falls into coffee tables cause traumatic pneumo with flail chest. Can't imagine what this would do

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes definitely looking forward to the expert coup takes today

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FlexNP

@rn_flex

1 year

@MortytheRN They dropped our incentive pay and now they're begging for help on a near daily basis.

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FlexNP

@rn_flex

7 months

93 days in the phase 3 clinical trial for retatrutide. I've lost 36.5lbs, or 15.2% of my starting body weight. Doubtful I'm on placebo as this is the lightest weight I've been in 20 years with no dietary or exercise changes besides slightly less intake. 🤯🤯 Magical drug! 🥹

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FlexNP

@rn_flex

7 months

@PsychDocStL I feel great. I have more energy. I sleep better most nights. I'm able exercise much easier. My anxiety has diminished so much that I've reduced my SSRI dose by 50%(with my docs blessing) I'm blown away by the positives, & the GI side effects have been minimal the whole time

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FlexNP

@rn_flex

1 year

@crabby30somthng Don't feel embarrassed you were doing your job with patient teaching. He should be embarrassed for interrupting you like that

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes I swear this is the universe telling me I should start selling some of my photography if folks are selling this kinda stuff. Like someone would buy this in a canvas print right?

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FlexNP

@rn_flex

2 years

@jbouie I will go out on a limb and say PREY is nearly as good as the original Predator. Beautiful cinematography, simple but effective plot. Doesn't try to be something it's not. Loved it

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FlexNP

@rn_flex

7 months

@DvsBlack Eli Lilly does. If all goes well in the trials it'll be on the market end of 2025/early 2026

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes In my clinical rotation legit today and got consulted for angry kidneys in the ICU s/p surgery. They're such little jerks.

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FlexNP

@rn_flex

2 years

@ShaneInKS2 @hankgreen And there are other countries who have this arrangement in place already and it works! I don't see why it wouldn't work here...except the political system for passing such a law is beyond repair at the moment

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FlexNP

@rn_flex

5 months

@slugo13 Sometimes in 2026 probably. The trial I'm in is gonna run end in summer 2025 for me.

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FlexNP

@rn_flex

5 months

@invisiblegirl99 Because there are no treatment options(yet) give it a few years. This drug I'm on will be available and a few others most likely

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FlexNP

@rn_flex

2 years

@theRNbiologist Stop the continuous bladder irrigation is absolutely my favorite order on the planet.

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FlexNP

@rn_flex

1 year

@crabby30somthng This job is all about continuous education and learning. In 15 years I've worked various ICU and ERs, was a HAZMAT technician part time for 4 years, ran a trauma program for 5, and so many more things. Hence my name. We're flexible. Never stop learning or asking questions

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FlexNP

@rn_flex

11 months

@TraumaSoapBoxes My current bigger problem as I try and work on grad school projects 😵‍💫

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FlexNP

@rn_flex

1 year

So any clear liquid in a mason jar in the South is moonshine until proven otherwise. In this case it's some real corn shine. Saturday night shine roll call y'all @TraumaSoapBoxes @kevin_ro @MortytheRN @shangib1999

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FlexNP

@rn_flex

11 months

@jtrebach @BassoonYsu What my eyes were telling a new ER attending when he wanted to intubate a patient with pneumonia and asthma 2 weeks ago. He heard me loud and clear just from a look. Deep suction, nebs and a lil vapotherm and all was well again

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FlexNP

@rn_flex

1 year

@TheBlondeRN Feel like this is the appropriate place and time to drop this meme

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FlexNP

@rn_flex

2 years

@kevin_ro Drink decaf coffee and be resilient

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FlexNP

@rn_flex

1 year

@crabby30somthng I use a $100 litman and it's served me well over many years

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FlexNP

@rn_flex

7 months

@gary_teroller Also, I have familial high cholesterol. Diet and exercise can't change my genetics. 9 weeks of this obliterated that issue. Also I've been able to exercise much easier having lost 25 pounds so the drug has allowed me to do *more* exercise than before

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes Facebook put a strike on my account because they said I was sexist when I said I hate when men act stupid about football. And I'm a guy. Not exactly a brain trust over there 🤦‍♂️

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FlexNP

@rn_flex

2 years

@kevin_ro @TraumaSoapBoxes Glad I'm off work today because:

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FlexNP

@rn_flex

2 years

@theRNbiologist I love being a zombie basket case who literally can't even do simple addition. The shift differential made up for that I suppose

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FlexNP

@rn_flex

2 years

@MortytheRN Be extra. The world is hot garbage at the moment

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FlexNP

@rn_flex

5 months

Well it's been 126 days since starting my clinical trial and I've lost 51 pounds. So uh. Not placebo. Whoa. Like WHOA. FIFTY ONE POUNDS. 21.3% of my starting body weight. Unreal.

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes Was literally just complaining last week that many nurses are so rigid in their adherence to rules/protocols that it's causing harm. What happened to critical thinking? What happened to thinking outside the box. I was raised to be a MacGuyver nurse. Feel like I'm a rare kind now

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes Reminds me of our neighborhood having to call the police on someone using a rifle for target practice in his BACKYARD. His backyard faced OTHER HOUSES. He claimed to the police he was just trying to protect the neighborhood. I'm so tired of this shit.

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FlexNP

@rn_flex

2 years

@HollyAnderson Happy hound year, if I can't see you, you can see me #houndcamouflage 5 mile trail run wore her out today

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes There's a reason I stopped working in trauma. There's a reason I'm not going to work in a hospital with my NP degree. There's a reason why people keep quitting. I had 28 in the ER lobby all by myself 2 weeks ago. It's not safe. It's mind numbingly dangerous.

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FlexNP

@rn_flex

5 months

@amyisquitebusy Bit of both? I can't eat nearly as much as I used to. Most days I aim for 1800-2000 calories. Any more than that and I'm literally 🤢🤢 because I will feel so over full. The glucagon part of the drug literally causes your body to burn fat for energy and increases metabolic rate

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FlexNP

@rn_flex

1 year

@hankgreen I think James Cameron mentioned they heard the initial bang and lost contact at around 3500 feet which is still 1550psi and 225,000 pounds/square foot but result is still the same for the implosion 😬

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FlexNP

@rn_flex

1 year

@nelson_rosen @TraumaSoapBoxes I go back to one of the best surgeons that I worked with, she would always tell her residents, you can order any test you want, but I need to hear how it's going to change your management of the patient. In this case a UDS does nothing for the patient or my management

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes IV fluids, which are terrible to give for acute blood loss anemia, were originally developed to help treat dehydration from diarrheal illnesses of which they are incredibly useful for saving lives.

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FlexNP

@rn_flex

5 months

@TheKnitHick I'll be in the trial until May of 2025. I'm past dose escalation and into what the research clinic calls maintenance phase until the end of the trial. I've already gone 20lbs under my goal weight so just focused on maintaining at this point.

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FlexNP

@rn_flex

2 years

@theRNbiologist Who the fuck pays $15 for a damn black bean burger

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes One *vital sign* to rule them all

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FlexNP

@rn_flex

2 years

@HollyAnderson Double your hounds! Double your fun!

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FlexNP

@rn_flex

2 years

@edsbs Breakfast carnitas taco with salsa verde and an over medium egg is literally God's breakfast

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FlexNP

@rn_flex

2 years

@theRNbiologist It was an absolute garbage fire burning in a floating river of detritus at work yesterday and they're texted 6 times in 4 hours begging for help and imma sit here and drink my blackberry lemonade, make some crispy oven fries and chill the F out with my family.

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FlexNP

@rn_flex

2 years

@notdred As my research professor would say. This doesn't even pass the initial smell test. Anecdotally, I ran side by side with a buddy of mine for a full half marathon while he(unknowingly) had COVID, no masks. No nothing. I never caught it. This was during the Delta wave.

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes it's the most wonderful time of the yeaaaarrrrr

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FlexNP

@rn_flex

7 months

7 deadly stouts. Celebrating my FNP degree today! Stout with vanilla, chocolate, cinnamon, coconut, hazelnuts and coffee aged in a blend of Scotch, rum, tequila, bourbon, maple bourbon, Cognac, and Apple Brandy barrels. Drink your heart out @TraumaSoapBoxes and @kevin_ro

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes How is that a problem? Make some pickled jalapenos for long term use and jalapeno poppers for short term use

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FlexNP

@rn_flex

2 years

@DrSandman11 Diet Dr Pepper >>>>>> Diet Pepsi >>>>>>>>>>>>>>>>>>>>> Diet Coke

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FlexNP

@rn_flex

2 years

@TheBlondeRN So I did some research and found out the bedrock that my neighborhood sits on is somewhere between 350 and 400 million years old

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FlexNP

@rn_flex

1 year

Starting Sunday morning off on the right foot

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FlexNP

@rn_flex

2 years

@theRNbiologist I'm being extra again. Chicken parmesan meatballs anyone? Tomato sauce made with tomatoes and herbs from the backyard garden.

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FlexNP

@rn_flex

2 years

@TheBlondeRN Watermelon marg

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FlexNP

@rn_flex

1 year

@nycsouthpaw Somehow I feel like this interview will play into said insurance decisions

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes I was told to fear docs but I just ignored that advice. Patient safety and care trumps falsely laid hierarchical BS. As such I've developed many great physician friendships over the years.

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FlexNP

@rn_flex

5 months

@Emaperidol Great the whole time no fatigue that I've noticed

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FlexNP

@rn_flex

1 year

@keithdunn @Ultra_Damo Hope someone reminds him of Leave No Trace, the boars at Frozen Head are strong enough, they don't need to get a taste for cherry limeade

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FlexNP

@rn_flex

5 months

@ijan808 Good article here, I'm in the phase 3 trial. Should be available in about 2 years

‘This raises the bar’: Phase 2 data show 24% weight loss with triple-agonist retatrutide

SAN DIEGO — Adults with obesity who received the highest dose of a once-weekly injection of retatrutide lost an average of 24.2% of their body weight at 48 weeks compared with placebo, data from a...

www.healio.com

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FlexNP

@rn_flex

1 year

@Selah923 As I was reading the question that was actually my first thought as well. I was actually Surprise, there wasn't something more about suicide or schizophrenia or some other psychiatric disorder that emerges in the late teenage years

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FlexNP

@rn_flex

7 months

@Tcvnurse Doing trials for T2DM, sleep apnea and osteoarthritis as well. It's gonna be a game changer.

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FlexNP

@rn_flex

1 year

@GoodishIntent Got choked up in therapy recently because we sent a patient home that I knew needed more assistance and the hospital case worker and MD only cared about the bare minimum. I pushed for better care until I literally got shouted down by a manager.

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FlexNP

@rn_flex

6 months

@meganmoze @TraumaSoapBoxes Protein shake while I'm swamped in ER triage one last time before I start my NP job.

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FlexNP

@rn_flex

1 year

@TraumaSoapBoxes @StressHoop Admin: bUT WhY aRe aLL tHE nUrSEs LeAVinG?!?! They ask with no sense of irony

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FlexNP

@rn_flex

1 year

Trail running on a sunny but slightly foggy morning on the spring. This is such a dopamine hit for me I can't even put it into words

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FlexNP

@rn_flex

11 months

@RNSuperHero Can't wait to start working outpatient as an NP. Cuz good lord nope on this stuff

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FlexNP

@rn_flex

2 years

@TraumaSoapBoxes @TheBlondeRN Ahh yes let me quit when I'm halfway through NP school and raising a small child. I'd quit in a HEARTBEAT if I actually could. But I can't until I'm done with my masters.

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