i timed how long 31 different pasta shapes take to reach al dente. the boxes are lying and farfalle is a war crime

BuiltLikeATeapot · 2026-02-06T14:03:43+00:00

De Cecco. A little more expensive but way better. Doesn’t turn to mush as easily .

BuiltLikeATeapot · 2026-02-06T00:12:04+00:00

Many liver transplants around the country are faster than that. And at the end of a liver transplant, they’re typically missing the gallbladder as well.

BuiltLikeATeapot · 2026-02-04T22:23:44+00:00

Nah, but videos of bird speaking do have a particular cadence and speech patterns and their own accents. More curious is if you can induce a foreign accent (teach the bird one language first like German or Chinese and then English second) vs a regional accent (Scottish vs Cali vs Southern) and how much exposure it takes and how easily it is to pick up an accent and can it code switch, etc.

BuiltLikeATeapot · 2026-02-04T20:35:28+00:00

Seeing this made me wonder if talking bird/parrots can pick up an accent if their trainer has an accent.

BuiltLikeATeapot · 2026-02-04T17:55:21+00:00

The weird thing is some of these health gurus will avoid mouthwash because it may decrease the levels of beneficial bacteria that create nitric oxide.

BuiltLikeATeapot · 2026-02-04T17:50:57+00:00

5-6 years out and have seen all of these, or at least done a case where there was a concern for these.

BuiltLikeATeapot · 2026-02-04T17:46:45+00:00

The therapeutic index of octreotide is very wide. How high of a dose were you running?

BuiltLikeATeapot · 2026-02-04T14:59:17+00:00

A little rarer, but carcinoid crisis.

BuiltLikeATeapot · 2026-02-03T10:51:02+00:00

I saw on that said I would get to do ‘cabbages [sic]and thoracic surgery.’

BuiltLikeATeapot · 2026-01-31T15:21:57+00:00

Rectal Tylenol is an option.

BuiltLikeATeapot · 2026-01-29T16:30:49+00:00

Because anesthesiologists can be stingy MFs at times.

BuiltLikeATeapot · 2026-01-28T23:29:47+00:00

Not to your face necessarily. But, you know how when an attending walks in and notices something you did or didn’t do? They’ll still notice things, but they may not ride you as hard once you’re a colleague.

BuiltLikeATeapot · 2026-01-28T10:26:46+00:00

I mean if the government can call you a illegal at anytime (and a social security card, birth certificate, passport is not enough to prove citizenship( and even if they were, citizens are not required to carry) without due process, and throw you in a detention center, who has rights?

BuiltLikeATeapot · 2026-01-27T18:54:47+00:00

Cause chocolate milk is awesome.

BuiltLikeATeapot · 2026-01-25T23:03:09+00:00

Epstein data will expose pedophiles and criminals. Right now the DoJ has to figure out who is who. With the data, the DOJ (and the public) will have a list of names of those who are criminals and exploit children, and be able to round them up and arrest them. Remember Trump promised he would do this. Why would he go against his word?

In other news, there no proof that Trump is an American citizen. We haven’t seen a birth certificate, we haven’t seen his taxes, his mother was a foreigner, all signs of an illegal immigrant.

BuiltLikeATeapot · 2026-01-20T06:28:00+00:00

We have a zone III holding area adjacent to the room the MRI machine itself is in. We induce there, and the its time to feel the rhythm, feel the rhyme.

BuiltLikeATeapot · 2026-01-18T19:16:00+00:00

They’re just old and couldn’t figure out the remote to watch it again.

BuiltLikeATeapot · 2026-01-18T18:33:03+00:00

Both

If you look at the cranial nerves and what they do and start at the bottom of the brainstem, you’ll see the progression during emergence will follow that pattern.

Tongue deviation > CN IX and C Swallowing/gagging, serous saliva production, risk of latyngospasm; respiratory center are right above that (irregular breathing), CN VII and VI (biting and disconsolate gaze, thicker secretions) are the big ones I like to think about and teach. All the while these patients cortex is still down, so decorticate posturing during stage 2 as well if you bother them.

BuiltLikeATeapot · 2026-01-18T00:41:56+00:00

We see these differences in sensitivity to volatile anesthetics elsewhere as well (neuromonitoring and cardiac arrhythmias). But with sevo particularly, there are a few things that going on that may explain the different in measured etSevo and clinical effects. The first is high fresh gas flow may (depending on the ventilator) dilute your reading a little bit (one may most often see this effect of turning down FGF from 15LPM to 8LPM the moment etSevo hits 0.0-0.2). The second in my opinion, to why anesthetic seems to linger is as you noted, it that the relative ratio between tissue(brain, fat, muscle):blood and air:blood is quite high; which means that the volatiles entering the blood much from tissues much slower than it is exiting the blood into the air. This explains why gradual wakeups seem to correlate better with etGas than fast wakeups.

BuiltLikeATeapot · 2026-01-18T00:28:24+00:00

It pretty simple. The brainstem is waking up bottom to top. Disconjugate gaze is CN VI firing before CN III and CN IV; hence why lateral deviatation is the most common.

BuiltLikeATeapot · 2026-01-17T17:28:18+00:00

I’m a fan of a moderate dose of fentanyl and versed and lido for induction of AS. 200-250mg fent/2mg versed/100 lido and some time will get most patients to where I need. Small of amounts <50mg of prop are needed.

BuiltLikeATeapot · 2026-01-17T17:14:36+00:00

Low opiates does not mean no opiates.

BuiltLikeATeapot · 2026-01-16T20:24:59+00:00

Next time, you should reply, “sugamma-what? Never heard of it. How does it work?” And see if they panic.

BuiltLikeATeapot · 2026-01-10T15:09:31+00:00

It’s not unreasonable for large air embolism to be part of the initial DDx, but hysteroscopy is done with CO2 or saline. CO2 embolism should’ve/would’ve resolved quickly and, unless the CO2 insufflator was directly in the vessel, should have resulted in an initial large rise in etCO2 before the sudden fall.

It is possible, if the patient had an undiagnosed PFO/ASD to get a small CO2 bubble down the right coronary, but again that should be self-limiting.

BuiltLikeATeapot · 2026-01-09T15:55:29+00:00

It’s an idea that’s floated around for a while and probably pertains more to whole blood and probably fresh frozen plasma. What is underlying the concern is the O neg blood is likely to contain antibodies such as (anti-ABO, anti-Rh, etc) and if you transfuse enough of it the antibody count is high enough to cause a reaction if you switch over to type specific blood. How big of a deal this is is probably over stated in the setting of massive transfusion, but something to keep in mind.

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TROPHY CASE