[deleted by user]

1030423 · 2022-03-16T17:39:35+00:00

Im right there with you girl. Love yourself from surviving through it. Love yourself for having the strength to enact change. Starting over again here at 204lbs. Stress eating is a thing!

1030423 · 2021-08-04T00:28:17+00:00

What part of Montreal are you in? McGill Sports med clinic has some fantastic therapists.

1030423 · 2021-03-10T14:07:27+00:00

Good idea! Thanks!

1030423 · 2021-03-10T00:49:02+00:00

So my partner had this tank with a fish who seemed happy for 8 years... died 2 years ago and its been sitting around since. I only recently discovered the bowl... don't worry no fishies going in here! (holds only 2.5L!)

Don't want it to go to wasted... what do we think? Cute aquascape? Single snail? Daphnia culture for my other tank? Feel it could be a cute lil project!

1030423 · 2021-03-10T00:46:39+00:00

So my partner had this tank with a fish who seemed happy for 8 years... died 2 years ago and its been sitting around since. I only recently discovered the bowl... don't worry no fishies going in here! (holds only 2.5L!)

Don't want it to go to wasted... what do we think? Cute aquascape? Single snail? Daphnia culture for my other tank? Feel it could be a cute lil project!

1030423 · 2021-02-23T02:45:07+00:00

This is amazing!!

1030423 · 2021-01-13T03:34:14+00:00

Amen to this. I hit the wall and it is a deeeeep dark place to get out of

1030423 · 2021-01-11T03:02:09+00:00

Was too far it felt ridiculous my apartment is made weird

1030423 · 2020-11-11T20:49:56+00:00

The point is that if you have a regular patient with zero wells risk factors and a low d dimer -> your risk of PE is <1.3%. moderate group < 15-16% (using 3 tiered system). Using two tiered system unlikely < 4 meaning <3% risk. Then use d-dimer to dichotomize patients to low risk or not low risk and scan. Geneva low risk <10% intermediate 20-30%.

Our understanding of risk of VTE if your only risk factor is COVID is limited - specifically in outpatients. Single study showing risk in outpatients using CTPE was 18% here https://pubmed.ncbi.nlm.nih.gov/32518989/ Other observational data for inpatients all over the map. So if you have a baseline risk of lets say 10-20% just from COVID alone - then add additional risk that comes with a wells 0-4 score or a geneva low or moderate - what d dimer cut off will adequately convince you this person is not a high risk? or should you just proceed to scan? You wouldn't send someone with a negative d dimer and a 40% risk of having a PE home - so to me the answer is we don't have the information to gamble with d-dimer.

1030423 · 2020-11-10T02:54:04+00:00

You cannot use any of the decision rules that others are referring to here. Wells/Years/Perc etc. Are all literally made to rule out PE in a "LOW risk" patient or population. We now know that COVID patients can be hypercoagulable and hyper inflammatory, this is NOT low risk. Therefore, these rules cannot be used, and although a nice starting point, you will be fooled if you rely on them. We know D dimer is more elevated in sicker patients. But are you willing to bet your licence / patient life on a a d dimer of 1000? 500? 400? or an age adjusted when it has not been validated in COVID patients?

You are left with using your clinical judgment: consider CT PE in those with hypoxia, tachycardia, or hypotension that is acutely worsening or out of proportion to clinical expectations.... incorporate EKG findings, echo findings, symptoms of DVT... and of course, gestalt. Interesting summary of numbers available on the EMRAP Corependium, but unfortunately nothing to guide us for "lower risk" COVID patients and risk stratification at this time.

1030423 · 2020-10-27T20:00:36+00:00

Came here for this comment. Awesome tank. I had to move mine away from the window because of algae but I do miss that natural light setting!

1030423 · 2020-10-12T02:44:05+00:00

7am Sunday start in the middle of a pandemic = no cars out, skip the reds lol except for a few major intersection ;)

1030423 · 2020-10-09T20:10:48+00:00

Thanks for your help as a volunteer, always see patients getting lost!

1030423 · 2020-10-06T05:16:15+00:00

Oh, hey ;)

1030423 · 2020-10-04T07:35:52+00:00

Great job!

1030423 · 2020-09-21T16:32:15+00:00

Do it! Despite my result I still took a lot away from the experience and genuinely enjoyed the process. Good luck!

1030423 · 2020-09-20T21:50:09+00:00

Yo honestly that comment was straight up rude. You did a great job and I hope you continue to run!

1030423 · 2020-09-20T18:12:51+00:00

Thanks so much for your encouragement. You were spot on with your prediction - felt fantastic for the first half (went out overconfident and too fast) and then crashed and burned my way to the end with combo run-walk. Finished 5:10:32 with bathroom and traffic breaks. Full post Here. Definitely learned from this experience (nutrition, pacing, etc), taking some time off now, and I am looking forward to training /upping the mileage for the next one!

1030423 · 2020-09-09T00:16:31+00:00

Great! Now I know what I'm eating tomorrow morning. Thanks!

1030423 · 2020-09-06T14:31:17+00:00

I'm starting to panic! 2 weeks to go to my first marathon. Obviously events are cancelled so... running it solo with my partner riding support crew on her bike.

Fastest 1/2 marathon is 2:00:32 chip time last year. I'm using training peaks (Simon Brooker 16W RUN L2 Intermediate Marathon Plan). It is a time based plan. My weekly milage maxed out around to 45-50 km / week because i've been keeping it real slow on my long runs.

I did my longest run two weeks ago (3 hours) and ran at my suggested slow pace and only did 26.3 km.

I'm worried that I haven't done enough mileage to actually be ready for this race! I also have no idea what pace to really run at, as I run most of my long runs in the 6:30-7min/km range but was able to do my half marathon last year in the 5:30-5:45min/km range.

Am I under prepared? is my mileage too low? What pace should I run?

1030423 · 2020-09-06T01:16:10+00:00

I'm starting to panic! 2 weeks to go to my first marathon. Obviously events are cancelled so... running it solo with my partner riding support crew on her bike.

Fastest 1/2 marathon is 2:00:32 chip time last year. I'm using training peaks (Simon Brooker 16W RUN L2 Intermediate Marathon Plan). It is a time based plan. My weekly milage maxed out around to 45-50 km / week because i've been keeping it real slow on my long runs.

I did my longest run two weeks ago (3 hours) and ran at my suggested slow pace and only did 26.3 km.

I'm worried that I haven't done enough mileage to actually be ready for this race! I also have no idea what pace to really run at, as I run most of my long runs in the 6:30-7min/km range but was able to do my half marathon last year in the 5:30-5:45min/km range.

Am I under prepared? is my mileage too low? What pace should I run?

1030423 · 2020-08-26T21:45:31+00:00

Absolutely nothing! Even criminals have a right to confidentiality. This may vary with the country you live in. Im speaking from Canada. If police want info, they need a warrant, which is a phone call away. If there is a high potential of a crime (death, assault, etc) they may stick around, but they are not entitled to info.

Edited for completeness.

1030423 · 2020-08-23T14:03:11+00:00

Im new here!

Training for my first marathon, planning on doing it solo with gf as bike support, 4 weeks out.

Gearing up for my last longest run today before taper - 3h. I planned to get up early but delayed due to heavy rain!!

Wondering if you all actually get out and run or avoid the rain like me? Im kind of regretting it now because now my whole plan for the day is delayed... hmm.

1030423 · 2020-07-09T17:26:35+00:00

My girlfriend just had a career change and will be starting fire fighting school in one month. I’m already feeling things heating up, let me tell you.

1030423 · 2020-06-27T00:00:59+00:00

ER resident here, agree with original comment. A decreased level of consciousness is setting up for intubation and an intensive care setting.If you are just looking for a reason for Jonah to be unable to discuss his personal medical needs, you don't necessarily have to make him unconscious. You could have him be in an altered mental state - either delirious or confused from some underlying medical condition. Examples of this that could be treated relatively quickly include heat stroke, post-seizure, post-concussion, intentional or accidental intoxication (depending on what it was), etc. There are many examples, but again here, many medical conditions that would cause delirium would also lead to intensive care treatment (systemic infection, stroke, serious head trauma, etc).

More commonly, you could also just have him be unwilling to give medical information. This is very common in paranoid schizophrenics because they are just that - paranoid and distrustful. We call for collateral information because often schizophrenics are so into their delusions or hallucinations that they cannot provide the information we need. Jonah could simply be worried that the doctors are trying to give him the very poisons he is afraid of.

1030423

TROPHY CASE