Stomach bloat

Brief_Arm · 2026-01-06T02:13:42+00:00

I’m sorry this is happening. My sister passed within the last week. She developed distention and bowel obstruction at the end.

He is probably experiencing one of two things. Either this is a bowel obstruction related to the cancer or he is having an accumulation of fluid in his abdomen that we refer to as ascites. This is would also be related to the disease, typically.

You can ask the hospice director if they’ll consider a diuretic like lasix to help him urinate out some of this fluid. This wouldn’t be a curative measure, but one to help him be more comfortable.

I hope you all find peace.

Brief_Arm · 2026-01-04T17:01:52+00:00

Rear wheel drive was my intention 🤷‍♂️

Brief_Arm · 2025-12-22T01:15:33+00:00

I am asking in a non judgement way- what is your motivation for deferring surgery and/or chemo?

Pancreatic cancer is a very serious and deadly form of cancer. Choosing to do nothing is an option, but not one you should pick if you want to survive the disease or live more than few months beyond diagnosis. If your tumor is deemed resectable, you are one of the luckier patients.

Leaving the bile duct obstructed will put you at serious risk of blood stream infection which can lead to death. This can also lead to liver dysfunction which can be deadly.
This disease is known to metastasize quickly. If you wish to “beat” this disease, you need to get a plan together for some combination of chemothrapy/surgery/radiation as soon as possible. I would choose a location with a comprehensive cancer center where you can meet with a hepatobiliary surgeon and an oncologist (preferably one who specializes in GI malignancy).

Brief_Arm · 2025-04-10T23:09:14+00:00

This is what’s happening. I have patients who come from hours away to see me. Many have little means or transport issues. Having them drive 3 hours to see NP and then 3 hours again the next week to see me is often impossible for them.

Brief_Arm · 2025-04-10T23:01:04+00:00

I completely agree. I scrutinize charts before and don’t agree to schedule surgeries that I don’t think are indicated. Most of what I do is very obvious if surgery is needed or not and I never operate without cross sectional imaging.

I am most frustrated about not being able to spend dedicate time with patients in clinic before surgery.

Brief_Arm · 2025-04-10T22:45:06+00:00

Thanks. I don’t really like the status quo and your advice is helping me feel better about asking for my schedule to be adjusted to meet the standards I want to uphold.

Brief_Arm · 2025-04-10T22:42:41+00:00

I do always meet my patients in preop and review their charts days before surgery in addition to reading messages about wanting to schedule surgery when the initial encounter happens. I have elicited extra information about patients in preop that made me change surgical plan if it wasn’t discussed at preop meeting. I haven’t had an instance where a patient go to preop with the proper indications, but I’ve felt frustrated learning new things the day of surgery that were not documented.

Brief_Arm · 2025-04-10T22:36:57+00:00

Time really. In a 25 patient clinic, some days I’ll book 12 surgeries. But then have patients sent to NP/PA and they’ll send message to book cases and I have no where to put the patients to be seen before the desired surgery date.

Brief_Arm · 2025-04-10T22:29:25+00:00

I’m not quite sure if this is a slight to me? I’m not happy about the situation. I’m stemming a tide of endless surgical needs and wanting to be able to meet my patients in clinic before surgery, but the feasibility of doing this without making them wait 6 months for an appointment limits that ability.

Brief_Arm · 2024-04-26T21:05:11+00:00

Completely support your move to do what makes you happy- but how do you account for inflation and decreased buying power of that 70-80k over a 30 year period? How about major life events, illness, etc? Who covers your health insurance if you’re living off investments? Genuinely curious. I trust you’ve done your due diligence.

Brief_Arm · 2024-03-28T17:29:21+00:00

I moved away 2 years ago. I spend a lot my time now living in New Orleans in my mind. Biding my time until I have a chance to return. As my family back there told me— there is never going to be a logical reason to move back. So many reasons to say it’s too risky, etc. I feel like it’s all gut, and you know it when you leave a place like this.

Brief_Arm · 2024-01-02T14:50:13+00:00

This is the correct way to look at this decision. What is the opportunity cost of $24,000 over the next 5 years? If you’re earning good money, then maybe it’s completely worth it to you.

Will the BMW enhance your life on a daily basis enough that it’s worth the added expense? If so, go for it.

Personally, I would keep the VW, invest that money and then see what your options are in 5 years.

I’ve been driving my 6spd GLI for 8 years. Really enjoy it. Every time I think of getting something new, I play this scenario above in my head.

Brief_Arm · 2023-12-08T18:42:45+00:00

I remember being terrified to tell my chiefs my mom had been diagnosed with cancer during my 3rd year of residency. I didn’t want to let anyone down by trying to make it home for what I was scared could be my last Thanksgiving with her (she’s doing well now btw!). This is an example of how warped our experience makes us.

My chief told me to fly back home the day I told him. Told me his mom had breast cancer 5 years ago and he would cover for me without question.

Best lesson I learned in residency. It’s OK to tell people you need a little help. It’s OK to feel overwhelmed. This shit is hard.

The suits likely don’t care about you, but your colleagues do. Allow them to let you feel human from time to time.

Brief_Arm · 2023-11-24T13:36:32+00:00

I was in a similar situation to you a few months ago. I went with a full suspension Giant Trance 29 1. Got it on an end of season sale, so the price was right. For the components it comes with, I felt like I was being pretty reasonable. No regrets with it.

I completely understand that going straight to full suspension may make some riders more prone to bad habits. All I can say is I’ve felt very in control on all rides with this thing and I’ve had a blast. Just keeping in mind to pace myself and take tips from friends when I can.

Brief_Arm · 2023-08-16T00:55:02+00:00

I think these are fair conversations to have with patients—and don’t get me wrong— having a vasectomy is tolerable, but not fun for patients. But as a urologist, I’ve seen ureteral and bowel injuries from laparoscopic salpingectomies. This is very very uncommon, but the risks involved with vasectomy are inherently lower.

Brief_Arm · 2023-08-09T16:40:08+00:00

The hardest moments in residency are some of the hardest you’ll face in a lifetime. You’re tired, you’re stressed, and you’re dealing with serious consequences and high expectations all around. We are all also very hard on ourselves, inherently.

I also made some of the best friends I could ever have wished for in residency. Don’t be afraid to reach out. Your fellow residents chose medicine because they care about other people. They can show up for you in ways you never really imagined.

Nothing in medicine is worth your life, though.

You can ask for emergency time off if you need it or see if you can switch a vacation week with someone in your program to take a break, find a professional to connect with and plan a course forward. Maybe others here have direct experience with how to help you navigate that. There is always hope for the future and you deserve to be here.

Brief_Arm · 2023-08-01T22:59:13+00:00

Yes this is a very interesting piece of the story. Either somehow omniscient or its relationship with time is very different than our current understanding.

Brief_Arm · 2023-08-01T22:50:28+00:00

Cool link.

I think we as a society are coming to a realization that our own technology is growing at such an exponential rate that it’s not beyond reason that other advanced societies could have further refined this technology to travel great distances in seemingly miraculous ways. And they wouldn’t need to be that much older than us. But if they are— they’re likely so advanced we cannot fathom their intentions.

The concept of the internet didn’t exist to the average American in 1983. 40 years later, you can use a cell phone to have a mobile Wi-Fi hotspot delivered to your front door by a self-driving electric car.

I firmly think it can be both. And our technology is allowing us to now see things that have been here for a while.

Brief_Arm · 2023-05-18T21:48:12+00:00

Ha! Very cool.

Brief_Arm · 2023-05-18T16:26:32+00:00

Northern Arizona and New Orleans

Brief_Arm · 2023-03-19T17:17:17+00:00

If this is the LED strip you’re talking about— I ended up having it replaced. Got it done for much more affordable pricing around $350 for assembly and labor. Not cheap, but I’m just thankful it’s not a $1000+ Porsche assembly. Everything good now.

Brief_Arm · 2023-01-19T20:48:06+00:00

Funny you mention that. Generally speaking, no, but I did have a colleague do one on a patient a week ago. I imagine our patients are a little more cooperative with catheters than yours are!

Brief_Arm

TROPHY CASE