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rnflex.bsky.social
FlexNP
@rnflex.bsky.social
2.5K followers 430 following 3.8K posts
Jack of all trades nurse practitioner, trail runner photographer, coonhound rescuer, lover of glucagon agonism in the liver, kidney and pancreas, fascinated by obesity medicine, retatrutide fan boy
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 8h
Fertility doc and her OBGYN both contribute it to the tirzepatide. Regulated her cycle better than any other treatment + weight loss. They see it enough that they have a name for it "Mounjaro Mommies"
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 8h
Considering there are tons of anecdotes of women who have reduction in their PCOS and endometriosis symptoms while being on GLP1 meds I won't be surprised.

Our second kid was a surprise because of tirzepatide. My wife was/is anovulatory as confirmed by fertility doc. Yet baby two happened!
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 8h
That being said, CEO of Eli Dave Ricks has said they will trial any indication for GLP-1 meds if they believe it can help and they seem evidence of benefit in their own trials. Which is why there's also a trial for orforglipron in hypertension too!

Wild times in big pharma.
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 8h
GLP1 meds have reached a point of absurdity in fixing things @proptermalone.bsky.social called them "Mary Sue ass drugs" and seeing this trial today from Eli Lilly confirms that notion. Stress incontinence?! I trained with a urogynecologist and I can't think of the mechanism besides weight loss
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 8h
Appreciate your kindness! Same for the LTPs. More good humans in the world! Kindness is not weakness.

(Also wish more of my local Orthos were like you)
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 9h
I can only imagine. I was glad we actually had 2 girls. I am not sure I could raise a boy in this environment 😔 kudos to you
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 9h
I have this feeling as well. And we do the same with our two littles. Just frustrating because *waves hands* all of the other things/people that I feel like I'm constantly battling against
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 10h
Foggy morning run on the TART trail in Northern Michigan to get Sunday started off on the right foot
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 13h
Glad you pointed out this play because to me as a layperson with some general knowledge of the game I was like WTF is this coverage?! It almost looked like prevent defense on first quick viewing. Just acres of green grass for USC
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 23h
We have now gone offline and are hiding in our blanket
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FlexNP @rnflex.bsky.social · 23h
Coonhounds ready for duty
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 1d
The one on the top right of the picture would absolutely tear your face off if you did, but the one that's all stretched out would be down for it 😍
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 1d
Little Croque Madame brunch today
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FlexNP @rnflex.bsky.social · 1d
Unit 1 and Unit 2 standing by for tummy rubs
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FlexNP @rnflex.bsky.social · 1d
Not paying the people with weapons and training to use them has worked out famously throughout history.
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 1d
Facebook is essentially completely unusable. Slop everywhere you look. Barely any content from my actual friends/family.
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
I only prescribe Rosu and pitavastatin alpha statins only
rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
That it's named .statinhell 😂😂
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
And I definitely don't like these sort of targeted trial emulations but it at least gives us an idea of potential benefit and once again the answer may well be GLP1 meds are like metabolic magic.
rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
"Tirzepatide (HR 0.53 [95% CI 0.40, 0.71]) and semaglutide (HR 0.81 [0.72, 0.90]) were associated with a significant reduction in the risk of incident major adverse liver outcomes" Tirzepatide again with an almost comical reduction but given it's mechanism on triglycerides that would make sense.
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
The next frontier for GLP-1 meds is liver disease. Semaglutide already has an indication for MASH now. Tirzepatide has a trial starting up in the next month for liver disease. This target trial emulation shows what we might see from such a trial.

pubmed.ncbi.nlm.nih.gov/40980971/
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FlexNP @rnflex.bsky.social · 2d
That's it exactly
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FlexNP @rnflex.bsky.social · 2d
Me as primary care NP who figured out how to bypass hematology for ordering iron infusions for my iron deficiency anemia patients who can't tolerate oral iron and are symptomatic AND get insurance to cover it:

CC: @shematologist.medsky.social
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
Absolutely!!! I mean CAD, HTN, HLD, prediabetic and fatty liver in addition to the OSA. He's literally a walking time bomb for poor outcomes and is also EXACTLY the patient who would benefit the most from a GLP-1 med!
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rnflex.bsky.social
FlexNP @rnflex.bsky.social · 2d
I think probably late 2018-2019. Second place would be the first 6 months of covid.
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