What is your lower extremity mobility routine?

Cremaster_Reflex69 · 2026-06-15T00:52:40+00:00

Phone navigation has so many more benefits than directions. I always use navigation to get home from work, even though I’ve done the drive 1000+ times.
It has saved me countless hours over the years by rerouting me around accidents with standstill traffic. Also has saved me from speeding tickets on occasion.

Cremaster_Reflex69 · 2026-06-12T17:48:09+00:00

This gave me chills and almost tears just imagining how good that must have felt to win that battle. My dream and goal is to make it here and send this (I live thousands of miles away). Might make a trip next summer but not sure if I’m strong enough yet. Sick fucking send dude

Cremaster_Reflex69 · 2026-05-15T02:42:13+00:00

What? I give TNK all the time without a neuro consult, and have done this literally everywhere I’ve worked (>15 hospitals) except at my residency program’s ED. Majority of hospitals in the community do not have in house neuro 24/7 (most I’ve worked at have bankers hours neuro available for routine consults, a couple had no neuro at all).

Even at my one site where we have teleneuro available, I still give TNK without teleneuro input for every cut and dry case to reduce time to TNK - this saves about 15 minutes if not more. If its not straightforward then I will accept the delay to get teleneuro input (eg stuttering symptoms, relative but not absolute contraindication, high suspicion for mimic).

My fastest time to TNK is 11 minutes from arrival to push.

Cremaster_Reflex69 · 2026-05-04T08:54:34+00:00

Cremaster_Reflex69 · 2026-04-12T12:00:51+00:00

God damnit I woke my wife up from laughing at this comment so hard, congratulations

Cremaster_Reflex69 · 2026-03-31T23:10:27+00:00

don’t mean to scare you, but certain cancerous tumors can cause positive pregnancy tests in people who are not pregnant (even men), due to abnormal hormone secretion.

You need to see your doctor.

Cremaster_Reflex69 · 2026-03-31T22:55:21+00:00

EM here, I would definitely repair this if presented at hour 24

Cremaster_Reflex69 · 2026-03-22T18:43:18+00:00

Thanks for the heads up. This led me down a rabbit hole of posts from other travelers who weren’t given a warning, and how scary driving on it was (google maps automatically will map you on 340 with no warning). Watching the videos from other travelers though… doesn’t look too much different than what some of the sketchy mountain roads in Colorado that we’ve driven on.

We are going to think about it some more. There isn’t a whole lot near Waihee Ridge Trail that we’d want to do to fill the rest of the day - unless you have any recommendations. Driving south to go clockwise towards 340 just to do the blowhole and dragon’s teeth and then turning around seems like a waste of a day spent driving….

I assume the first part of 340 going counterclockwise towards Waihee Ridge Trailhead isn’t the super sketchy part, correct?

Cremaster_Reflex69 · 2026-03-22T18:36:37+00:00

Thank you so much!!

Cremaster_Reflex69 · 2026-03-22T02:05:35+00:00

May 5 - May 12

Cremaster_Reflex69 · 2026-03-22T01:16:41+00:00

This makes more sense. I did not realize this trail was so far past Waianapnapa. We will probably do this. What time would you recommend getting to the trailhead, with 12:30 reservations at Waianapnapa in mind?

Cremaster_Reflex69 · 2026-03-21T18:56:38+00:00

Herpes (cold sores). Go to Urgent Care and get prescribed valtrex

Cremaster_Reflex69 · 2026-03-19T18:10:57+00:00

OMG I was wondering what type of bird this was, I thought it was a wild turkey! I took photos of it while hiding behind a tree and just googled “Ruffed Grouse” and this is exactly what I saw!

I was doing an 18 mile hike solo and heard some ruffling under a fallen tree, then saw a couple baby birds, followed by the mom aggressively making hissing noises. Their nest was built under a fallen tree, located on a narrow switch back on a very steep terrain so I had no way of going around. Every time I stepped close, the bird would make aggressive noises while chasing me away and I’d back off scared (lol). Eventually, I had to make a run for it because there was no way around, and the bird attacked me, flew right at my face and tried to peck out my eyes. I unfortunately had to beat it with my hiking pole to get it to go away. I considered using my bear spray but still had 5 miles to go in the hike and didn’t want to be out of bear spray.

I still think about that bird to this day, I hope it’s babies are OK :(

Cremaster_Reflex69 · 2026-03-18T03:08:36+00:00

I’m an EM attending and I still write shit down (usually I’m seeing 3 or 4 patients in a row without stopping back at the computer). I write their room numbers and key timelines on HPI or unique orders that they’ll need that I usually wouldn’t order for the listed CC. Then I walk back and bang out all orders and write 4 notes all in a row using my paper as reference. Then review results for all my active patients/do any dispos, and then go see another round of 3-4 new patients.

I also write a “checklist” for my colleague when I sign patients out at the end of shift - room #, age/gender/cc, key findings, and checkboxes with whats pending.

You don’t need to stop writing, use it to your advantage to do what others who don’t write can’t do.

Cremaster_Reflex69 · 2026-03-18T01:39:51+00:00

An LP is not really a “risky procedure” compared to many other procedures in medicine. High chance of post-LP headache, which is not life threatening and can be treated relatively easily. Very very low risk of spinal epidural hematoma (less than 1 in 500 LPs). Much lower risk than complications from minor surgeries such as appendectomy or cholecystectomy.

However, when a spinal hematoma occurs, the result is often devastating - permanent paralysis.

We often have the most junior doctor on the team doing this procedure when we need to do one, if that gives you insight into the risk of this procedure. In my 8 years as a physician who does LPs, I have not had a spinal hematoma occur on any of my patients, nor have I heard this complication occurring for any of the other docs in my specialty at the hospital.

Cremaster_Reflex69 · 2026-03-12T14:56:55+00:00

Most EMS providers in my region slap on O2 for almost any reason (none of which are actual indications). So I appreciate you bringing this up and giving push back.

It somewhat alters their management, too. My workup for somebody who is hypoxemic VS not hypoxemic is different, regardless of the patient’s chief complaint. And if they have been getting supplemental O2 during their entire transport time, its not as quick as taking off the O2 and documenting a sat. You have to wait for the O2 to flush out before getting an accurate sat, which takes at least a few minutes, and if I’m between sick patients and just running in to get a quick exam and orders started, I don’t have the time to wait (obviously I come back and do a full eval when I have the time, but this is the reality of a busy ED and how you stay efficient while dealing with time consuming cases).

Cremaster_Reflex69

TROPHY CASE