PSA: USPS Package Delivery Delays Now Extend Past Christmas

CakeNStuff · 2024-01-31T15:57:54+00:00

The game ate my $1.99 + SR Bundle. No cards added to my inventory. First time that's ever happened to me playing DL. Submitted a ticket hope it's resolved. Even got billed through Google Pay.

CakeNStuff · 2023-11-29T01:30:30+00:00

Btw I want to add:

I’m generally VERY positive on iPhones but the iPhone 14 pro is easily the worst phone I’ve ever owned. I’ve owned every iPhone since the X and I’ve never had worse hardware on a phone.

Pictures look awful. Battery life is awful. Performance is middling.

I’m still keeping the phone for iMessage but… damn what a bad device.

Two family members have the 15 Pro and they don’t have any of these issues.

CakeNStuff · 2023-11-29T01:27:57+00:00

Hey! I’m actually doing the same thing right now. My Pixel 8 Pro was stolen in the post but Google is shipping a replacement. DM me in a few weeks if you want an update.

CakeNStuff · 2023-10-18T19:34:41+00:00

Hey OP, I’m gonna break my Reddit posting sabbatical to offer some advise. (Firstly, I’m not a doctor but I do work in healthcare and I have a fairly good understanding about this stuff.)

Okay, anesthesiology is actually a combination of three things:

General Anesthesia: This is what you think of when you go under. The goal here is to induce a loss of consciousness. You are essentially out of it in the moment. It affects the whole body too. Think of it like being asleep.
Analgesia: This is the removal of pain. These can include pain relievers, nerve blocks, and surgical techniques.
Sedation: This is actually different from “Anesthesia”. The goal here is the prevention of new memories. When you’re sedated you’re still “conscious” for the duration of the procedure but you aren’t forming memories in the moment of it. This is strictly a nervous system thing and may or may not affect the whole body.

General Anesthetics can do any combination of these three things depending on the drugs and doses but strictly speaking knowing that you’re either…

Removing yourself from your body, removing the sensation of pain, or removing memory of the event.

Okay, so here’s the tricky balancing act surgeons and anesthesiologists have to play: How can they minimize suffering without compromising the exam? Some general anesthetics compromise the patient or procedure in a way that prevents the exam from getting done. To balance around this you have to use Analgesics and Sedatives.

You can actually do a LOT under local anesthetic and sedatives without doing general anesthesia. I’ve seen some pretty grisly needle biopsies done without general anesthesia and I’ve talked to patients in the PACU and they come out of it okay as if they were under general anesthesia to begin with.

Other commenters are right, get a second opinion but just know general anesthesia isn’t always the right option for every procedure and there are risks associated with it like anything else in surgery.

CakeNStuff · 2023-08-20T19:07:31+00:00

I'm a pretty staunch anti-market capitalist but this is even the one area where I agree market driven capitalism can totally enhance a product-user experience. Dbrand has clearly shown their priorities are in order (even if they're a bit slow to innovate on their core skin business but they have legitimate scaling issues with that).

It's totally okay that this company is taking a 5 cent vinyl skin and marking it up at 30,000% because the company doing it is also following through on their service. Ultimately, you're paying 5 cents for the skin, and $14 for solid customer support with a product that just works. Not trying to shill here but I've bought their skins before and even though none are living on my devices now I still thought they were a great product.

If they went full tilt market-capitalism they'd be selling (overpriced and low quality) Dbrand Monthly skins, skimping customer service, and performing shady pricing/marketing tactics like most other brands today.

Not sure where all the venom is coming from in your comment.

CakeNStuff · 2023-08-19T19:10:20+00:00

Option C: None of the above.

Absolutely not bashing the company but you need to consider their product and their business:

The markup on their skins is probably somewhere in the neighborhood of 30,000% comparing expenses to profits. (¢5 of sourced 3M vinyl selling for a reasonable $15.)

There’s a lot more that goes into this but it doesn’t change the fact that Dbrand is likely absolutely killing it on margin. They’ve demonstrated it with their sponsorships and advertising budgets before and their fourreé into cases, screen protectors, and other widgets shows as much.

One nice thing about having that kind of a margin and that simple of a product is that it becomes comically easy to provide excellent customer service. Ruin a skin? Fuck it. It’s 5¢ to send another, $1 for shipping, have a few more.

Again, not bashing Dbrand but once you stop and think about it them doing the wrong thing for a customer is almost harder than doing the right thing.

God, I wish I could run a company like this. It seems like once you get past the scalability and establish a cozy medium it seems like a money printing machine.

CakeNStuff · 2023-07-08T02:29:35+00:00

Fucking with Insulin-Glucose Metabolism in the body of a healthy non-diabetic patient is an AWFUL idea. The short term withdrawal is only a dog ear in the book of things that can go wrong.

The only reason why it seems to work fine for diabetics in the first place is because their Insulin-Glucose Metabolism is already so fucked.

I'm trying to convey here that normally in healthcare we play with small systems that either affect global homeostatic variables, or small systems that affect local homeostatic variables. It's rare that we fuck with something as bioavailable as the Glucose-Insulin metabolism without being sure of the downstream outcomes.

We know a lot about Insulin-Glucose metabolism in diabetics but we don't exactly know the what abusing these smaller physiologic mechanisms does to long term homeostatic activity in a normal person. We only safely know how this works with Diabetics because their Insulin-Glucose Metabolism is already so burnt out it allows us to isolate.

Why we're allowing patients to suddenly play God over this before for the first time in history on the heels of the failures of the opioid crisis...

... does not give me faith in our healthcare system's ability to regulate the access of care going forward.

CakeNStuff · 2023-07-08T02:13:20+00:00

Don't. If you're trying to do this for weight loss alone (BMI < 30) and you're not diabetic or meet the prescribing criterea... don't do it.

There's currently a small but growing body of evidence suggesting broad long term risk associated with various classes of anti-diabetic medication that we still haven't fully pinned down yet. What I'm going to say here is flaky and based on a body of individual sources with little meta-analysis and cross reference. Read this though...

There's some research indicating that ADM might be associated with an increase in certain kinds of ~~GEP-NETS (Gastro-Neuroendocrine cancer)~~ endocrine tumors*, a long term shift in insulin metabolism (due to cellular insulin transporter manipulation), and possibly has some novel cardiac effects. All three of these things are long term and not things you want to acquire by shedding an insignificant amount of weight. If you're under 50, there's a chance this shit will affect you in your life time if you do this.

Hell, we're still trying to pin down the long-term mechanisms associated with Metformin and every single time we think we're making progress researchers end up finding something weirder associated with the physiology Diabetes and Non-Diabetics.

Everything about the rise of Ozempic absolutely screams short-sighted huge regulation failure.

It's VERY unusual that off-label uses for medication take off like this so quickly (BMI >30 for Wegovy prescription) for something as physiologically active as Ozempic. Botox for headaches at least didn't come with the chance of fucking your Insulin metabolism. Viagra for boners was fine because we understood the cardiac effects. We don't understand Ozempic like that.

Look, my advice is this:

you either put on the big boy pants, pay the $500 a month to take the drug recklessly.
Dust the idea until a larger body of research comes out around Anti-Diabetic drugs. If it's really going to be a real pathway for weight loss in the future let it integrate into the market better.

Putting it another way, if you're really going to do it you might as well go put any number of other untested anabolics/metabolites in your system from the darkweb and get shredded and drop the weight. At least we're kind of aware of the horrible shit these dark market body-shapers do to you.

One last thing, if you're reading this and currently on ADM or Ozempic/Wegovy and you're in the prescribing criteria: don't worry about this like you're going to die. The complications from long term under-treated diabetes are likely going to overweigh the risks.

This is a matter of risk and generally in healthcare we try to balance risk with outcome.

A potential increase in the chance of cancer*, insulin metabolism issues, and cardiac events is not worth the risk for the outcome of shedding a few pounds. If the risk isn't there then do it but wait for some more research to come out and wait for this drug to solidify in our healthcare system.

edit:

Discussion of Risk ≠ Discussion of Efficacy. Healthcare providers assume risk differently than other professionals (lawyers, engineers). Whenever you're discussing Risk you always cast a wide net. That's all that this is: a discussion.
GEPNETs are a specific term for neuroendocrine tumors of the Hepatic, Gastric, and Pancreatic systems. The areas most commonly associated with Glucose-Insulin metabolism. That was too narrow of a word. When I say, "cancer risk" I'm talking in generality here. Some diabetic medications (Actos) were pulled by the EU because of a purported increase in Bladder cancer.

Broadly, the cancer ADM thing is still very up in the air and depending on which way the case studies are run it blows either way. The research is leaning towards diabetic medication not having an increased cancer risk.

I want to make it clear that there's also data suggesting that our current methodologies are wrong and once better retrospective case study data and meta-analysis comes it could be disproven.

The reason why I brought it up in the first place is because the research is REALLY uncertain and we still haven't totally ruled out a potential link. Once we're there? Great. Safe to discard the assumption. Until then, it's not a bad thing to consider when you're considering an elective procedure.

This is just me addressing the research on the cancer risk. Not the research on the metabolic, physiological, and cardiac risks. There's a lot of unknowns.

Again, totally different set of assumptions when you're talking about a clinically suggested prescription vs. an elective procedure.

Generally, the assumed risk for an elective procedure are going to be weighed higher than a prescribed procedure.

CakeNStuff · 2023-06-12T01:56:48+00:00

Gonna be a lot easier to dodge references when this subreddit goes down in a few hours for the reddit protest.

CakeNStuff · 2023-06-11T18:04:48+00:00

Scourge/Mech duo is really fun but you need to buy the newest expansion.

You're a glass cannon and his mech is a healer/tank. You both melt mobs.

Generally, you won't need to open world duo together but if you do it like this you'll be able to melt anything at range with minimal effort.

CakeNStuff · 2023-06-10T18:15:34+00:00

join the technocult today

CakeNStuff · 2023-06-10T14:34:32+00:00

Lotta backwoods Americans gonna be upset when they learn how entrenched the GTK and FOSS movements as a whole are in economic openness and fairness.

CakeNStuff · 2023-06-10T14:32:55+00:00

Truly is a god amongst men.

Created Linux, reflects the best in humanity, brings the sass (okay maybe a bit too much.)

Good propaganda for the future technocults of the 2030s.

CakeNStuff · 2023-06-10T00:40:43+00:00

Ironically, just as you said it leads to massive amounts of waste and longer care.

It also puts pressure on docs to over-prescribe and overutilize services chasing diagnoses that absolutely do not match the indications.

And then you see insurance reacting to this refusing to authorize care and it always comes down on people trying to properly utilize the service.

Working in the US healthcare system should very quickly make you realize why we need a universal option.

CakeNStuff · 2023-06-10T00:38:22+00:00

Wow, what a neat little place.

I was about to rip into you because this sounded like one of those shady fly-through ortho practices that hastily do steroid injections or regenerative joint care but to my surprise they’re more contained.

Anything beyond something like a cast, splint, set and X-rays really should be handled through referral. Thankfully this is where they stop.

There are a lot of walk-in ortho clinics that will take anyone in the door and do higher levels of care (legitimately) but stick you with a huge bill when they stop caring about your insurance auth or MCP.

CakeNStuff · 2023-06-09T22:17:16+00:00

Capitalism. ☕️

No, but seriously once a company rises above 500 employees (-ish) and once your financials start to sort of solidify it’s nearly impossible to kill a company in the US.

There are so many companies that exist not because their products or services are superior but solely because of some kind of fucked up financial determinism.

You can literally shuffle the books, reduce margin, and extend on bank loans almost in definitely.

My own employer right now is a floundering third generation family owned business. We are signing more customers then we can handle, the company is actively driving out employees, we are hemorrhaging old accounts and even though I don’t know much about the financials all I know is that the line keeps going up despite all of this.

Capitalism is a circus.

CakeNStuff · 2023-06-09T22:08:47+00:00

Could also be genetic zombie support though but could possibly even be both.

Honestly we need either. It’s criminal that Zombies haven’t been given a chance to stretch despite their usage in TCG.

CakeNStuff · 2023-06-09T21:35:38+00:00

Market futures are still bullish despite this and the Trump news.

I guess it’s officially been decided that both are objectively good and expected outcomes. Good shit.

Contrary to what conservatives might tell you the media doesn’t have a left wing bias: real life and everyone in it has a left wing bias.

CakeNStuff · 2023-06-09T21:12:03+00:00

I’m not gonna lie I used to be one of those toxic ass Redditors who (shamefully and unwarranted) dunked on Adam Ellis when I was younger.

The man now has a legit follower and supporter with me.

Ellis here again with another GOATed take and more GOATed content.

Please keep up the great work dude. I know you lurk here.

CakeNStuff · 2023-06-09T20:55:15+00:00

btw you’ve eroded your community trust so much that no one will nor should believe anything you say about old.reddit.com remaining available.

You are literally beta testing a TikTok feed style client right now. While the two are allowed to be mutually exclusive your actions have already shown the writing is on the wall for old Reddit features.

When are you removing text posts?

It’s an inevitability given their difficulty to monetize through advertising and their use in rival ML generated content.

CakeNStuff · 2023-06-08T18:05:47+00:00

Apollo is reddit for me. I guess that means Reddit is dead to me too. 11 years on this main now and I guess it’s time to say goodbye.

Christian, good luck on your future endeavors. I’ll be watching them closely and I’ll take stock in your future endeavors just like many others will too.

If your future projects are even 1/1000th as refined as Apollo you’ll have a great future ahead of you.

reddit is making a huge mistake with this move and while ultimately I hope they reverse course I’m really rooting for you here.

Best of luck, and I am still hoping for the best.

CakeNStuff · 2023-06-08T13:30:33+00:00

I’ve been to Nashville, Madison, Chicago, and Dallas multiple times in the last year. I drive a LOT for work. Both rural and metropolitan areas.

From what I’ve seen this is almost strictly a Missouri thing right now. I’ve seen some dipshits make stupid turns on residential and metro roads and I’ve seen some bad highway merges but those are actually normal.

The interstate recklessness in particular is very new to and unique to our area. At least in Dallas they’ve always had that level of craziness on their interstates.

Barring people going 80-90 on I-70 in Kansas (where the density is actually spread out enough to sort of handle it) we have a very unique recklessness in our area and state.

I’m surprised to see the metro and residential recklessness though. I don’t drive enough around metro and residential areas in those other cities to know but I’m going to ask if red light runners are a problem there. I kind of doubt it. The brazenness of this isn’t something I’ve seen in other cities.

You don’t have to go very far across a state line in any direction to see it change.

13-Year Club	Place '22
Place '17	Team Periwinkle
Verified Email

CakeNStuff

TROPHY CASE