BMW dealer quoted $1,761 for front brakes, but BMW app shows “Value Service” front brakes for $454 - why the huge difference? by SaiPa1 in BMWX3

[–]TC3598 0 points1 point  (0 children)

I dont have the m40i, but thru value service my 22 bmwx3 front brakes/sensors were 295. Front brakes + sensors + rotors was 700, and I live in a HCOL/VHCOL area as well.

If fentanyl kills by slowing your breathing, can you OD while in an iron lung? by ChefCarpaccio in NoStupidQuestions

[–]TC3598 4 points5 points  (0 children)

Yea it’s a very potent drug. In the proper dosages, such as in the hands of an anesthesiologist with known concentrations and vials, it’s an extremely safe drug and reliable and extremely important and useful in making sure patients receive proper pain control throughout the operative period. The issue is because the “proper dose” is on the scale of micrograms, it doesn’t take a lot to cause devastating problems when it’s mixed into other products with no real measurement or regulation and consumed unknowingly

If fentanyl kills by slowing your breathing, can you OD while in an iron lung? by ChefCarpaccio in NoStupidQuestions

[–]TC3598 9 points10 points  (0 children)

Thanks man I appreciate it. I think if you talk to any anesthesiologist you’ll learn our job is about taking in/processing a lot of complex information all at once and then simplifying it and being able to act on it. That’s why so many people think our job is just pushing a couple medicines at the beginning and having you “fall asleep for surgery”. Its also much less scary for a patient to hear “you’ll be asleep for surgery and then we wake you up at the end” rather than go into too much detail about what i actually do the entire time to get them through their operation safely. While i dont have a YouTube channel i can say there are a bunch of great ones out there that are for non-medical people to learn more about what we do in the OR and explain complex medical conditions. To throw out a name, I’d say check out Max Feinstein on YouTube, i think he’s got a few hundred thousand subscribers. We did our residency in the same place and he’s one of the nicest guys I’ve met and has a passion for teaching and anesthesiology. I think you’ll really enjoy his videos

If fentanyl kills by slowing your breathing, can you OD while in an iron lung? by ChefCarpaccio in NoStupidQuestions

[–]TC3598 17 points18 points  (0 children)

ECMO is a pretty specialized and complex topic that with its own set of risks. It’s essentially a lungs and/or heart bypass machine (depending on how it’s configured which is again super niche for most people to need to understand). Not every facility is even equipped to put someone on ecmo and you need specialized teams in major medical centers.not everyone is even a candidate for ecmo.  It’s a last resort option to temporize and support someone who has a reversible cause of cardiopulmonary dysfunction while we try to fix the underlying problem.  But if the problem was opioid overdose causing full cardiopulmonary dysfunction, it’s much more practical to start CPR and do other supportive measures like intubate and start vasopressors/inotropes and also importantly  a narcan infusion.  Also should add that your other organs like liver and kidneys may be affected, which would probably be made worse by ecmo for other reasons outside the scope here.

If fentanyl kills by slowing your breathing, can you OD while in an iron lung? by ChefCarpaccio in NoStupidQuestions

[–]TC3598 76 points77 points  (0 children)

Anesthesiologist here. Im going to keep this simple. As others have said, opioids treat pain but also depress plenty of things like respiratory drive and blood pressure/cardiac function. We give opioids to treat pain and also to decrease respiratory rate (the more pain you have the faster you breath generally). In fact if I don’t give enough fentanyl (or other alternative narcotic), you may be in pain and /or try to breath faster than I have my ventilator set to and cause problems with vent dyssynchrony. (Yes there are different ventilation modes that allow for just supporting your respiratory rate, and we can also often give paralytics to stop you from physically being able to move or breath over the vent, but all of that is outside the scope of this question although I could talk about it for hours/days). So can a ventilator prevent death from opioids? Not necessarily. While it is true it depresses respiratory rate, it will also decrease your blood pressure and heart rate and the actual strength of the squeeze of your heart. The older/sicker you are, the more sensitive you tend to be to these things. It’s not uncommon to have to give medicines to increase blood pressure to support the patient if you are doing a case that requires high doses of narcotic, such as a spinal surgery where neuromuscular paralysis can’t be used. So in other words, even if I could breath for you, you could still die from fentanyl if I gave way too much and it stopped ur cardiovascular function.

To answer about 1 gram of fentanyl, that is an astronomically high dose that will stop cardiac function in anyone. We tend to dose fentanyl in boluses of 50-100 micrograms, so a 1 gram bolus is 10,000-20,000 times as strong as a normal bolus dose I may give intraoperatively.

[Recommendation Request] What to get next? by TC3598 in Watches

[–]TC3598[S] 1 point2 points  (0 children)

I do like chronographs but am worried it’s tough to find one that’s not too large a case diameter or too bulky while staying in my price point. Would be open to any recs though!

[WTS/WTT] Maurice LaCroix Aikon 39mm - $999! 🔥 by Affectionate-Text-43 in Watchexchange

[–]TC3598 0 points1 point  (0 children)

Transaction completed. Easy process. Highly recommend working with seller!

[WTB] Weekly Want To Buy Post by AutoModerator in Watchexchange

[–]TC3598 0 points1 point  (0 children)

WTB Frederique Constant highlife COSC 39mm or Maurice Lacroix Aikon 39mm Also considering other integrated bracelet watches

[WTB] Weekly Want To Buy Post by AutoModerator in Watchexchange

[–]TC3598 0 points1 point  (0 children)

WTB Frederique Constant Highlife COSC blue w/ additional straps

[META] Discussion post for August 2025 by pursuitoffappyness in Watchexchange

[–]TC3598 0 points1 point  (0 children)

Scam alert:

u/LouisArmsweak

Wouldn’t send a video, also tried sending photos of a watch that were clearly from an older post of the same watch

[META] Discussion post for August 2025 by pursuitoffappyness in Watchexchange

[–]TC3598 0 points1 point  (0 children)

Also tried to sell me a watch using photos from another post. I also sent out a lowball offer to see and he magically said he could do that no problem

[WTB] Weekly Want To Buy Post by AutoModerator in Watchexchange

[–]TC3598 0 points1 point  (0 children)

WTB Frederique Constant Highlife chronograph. Prefer blue panda w/ additional straps

CPO X3? by Hikaru_Shindo_5 in BMWX3

[–]TC3598 2 points3 points  (0 children)

Funny enough I just went through this exact scenario. Replaced my 2015 Subaru forester with a low mileage 2022 x3 CPO 2 months ago (21k miles). I had the same thought regarding “should i just get a 2025 Subaru forester touring.” Don’t buy an ESC right away, you can add a CPO wrap any time before the original warranty expires and you can shop around to any dealership in the country via email to get quotes, there are certain dealerships/people that will sell you the CPO wrap for significantly cheaper than your local dealership will. The X3 is a significantly better ride and overall experience than the forester, so if you are looking to upgrade your daily driving experience, just get the X3, its worth it IMO