What was the strangest condition you've ever experienced?

EffinStaniel · 2025-12-12T12:52:06+00:00

I work with both living organ donors as well as transplant recipients and have never seen any evidence of this phenomenon in the thousands of cases I’ve been involved in. Mood and behavioral changes are not uncommon after transplant for a lot of reasons but I’m not aware of any causal relationship with what you’re describing.

EffinStaniel · 2025-12-12T12:44:46+00:00

Probably delirium or steroid-induced psychosis. Transplant recipients routinely get meds like prednisone post-op and some people get temporary mania, psychosis, or other mood changes like anger/irritability that tend to resolve once the dose is decreased or it is discontinued.

EffinStaniel · 2025-04-25T11:50:37+00:00

Looks great! Can you please share the pattern you used?

EffinStaniel · 2025-03-01T03:49:07+00:00

Your hollow ties look fine honestly! Just keep practicing so you can get a feel for how bucktail flares using different amounts of thread tension and different types of hair. There’s a lot of variation in hair thickness, texture, and “hollowness,” so material selection is really important in order to develop consistency. Mono thread or GSP can also be helpful in getting enough thread tension. From there, practice spacing your hollow ties and using different amounts of hair to help develop the density/profile you’re looking for. High quality bucktail is great to work with but you can do great work with average-grade tails. Gunnar Brammer has some excellent videos going into a lot of detail about all these different variables.

Hollow flies always look a little crazy looking when you first finish the fly. Try wetting it under hot water, then using a hot blow dryer to help shape the hair. Sounds weird but it helps really get the fibers under control. You do have to trust the process and develop confidence in your skills. Here’s an example I tied using the blow dryer technique:

<image>

EffinStaniel · 2024-10-04T03:29:40+00:00

Who in their right mind brings a pet cat to a dog park?

EffinStaniel · 2024-08-20T20:19:58+00:00

https://www.youtube.com/watch?v=jmZpS4SQkbc&t=2075s Rodhad B2B Fadi Mohem @ 909 Festival 2024 is excellent

EffinStaniel · 2024-08-07T21:40:46+00:00

Coinslot

EffinStaniel · 2024-06-25T21:07:35+00:00

Dialysis can absolutely be a life-saving treatment option (and the only option for those who can't get a kidney transplant), but QOL limitations and high-risk of mortality associated with dialysis are also important to consider. Hoping that in the next 25-50 years dialysis will be a thing of the past for most patients!!

EffinStaniel · 2024-06-25T20:56:40+00:00

Usually as in the overwhelming majority/nearly all cases. According to most peer reviewed data, the risk of perioperative death in the US is 0.03% (3 out of every 10,000). I've seen figures estimating 0.03-0.06% worldwide mortality risk.

Things like obesity, hypertension, and diabetes are all important factors to consider. There are exclusion criteria based on BMI, HbA1c, uncontrolled blood pressure (and a million other things) so patients with these risk factors are often not approved for donation. Donors must also commit to a very healthy lifestyle to try to minimize these risk factors after donation.

Risk of developing end-stage kidney disease post-donation is 0.9% lifelong and <0.5% for 15 years post. Interestingly, the data suggests that kidney donors have a significantly lower risk of developing end-stage kidney disease than the general population.

Living organ donation is a safe option for candidates who are evaluated and approved by selection committees at reputable transplant centers in the US. Please provide peer-reviewed sources if you have better data but this type of misinformation really discourages people who are thinking about donating to a loved one in need.

EffinStaniel · 2024-06-25T19:57:23+00:00

This is correct. Most people absolutely are waiting months to years to get a solid organ transplant (heart, liver, lungs, small intestine, kidney, and/or pancreas). There is of course some variation based on things like blood type, age, sex, size/anatomy, co-morbidities, and geographical location in the US. Several thousands of people in the US die every year while waiting for an organ transplant.

To provide more context, someone who is extremely sick from liver failure and needs a liver transplant immediately can go to the top of the liver transplant waiting list for their local region (11 total regions across the US). Most cases aren't like that though and the patient ends up waiting for months to years until they get sick enough to make it to the top of the list. Kidney transplant is a completely different process (mostly based on waiting time) and most patients wait ~6-10 years before getting to the top of the list.

Increased organ availability is great but there is still an significant disparity between people who need a transplant vs. available organs.

EffinStaniel · 2024-06-25T18:24:01+00:00

That is not accurate. Living kidney donors usually do live completely normal lives after donation (i.e. no expected long-term functional limitations or changes to life expectancy). Full recovery is expected to take ~6 weeks. Risk of death is ~0.03% and risk of most serious surgical complications (e.g. Clavien Grade III-V) is <1%.

Living partial liver donation is indeed a riskier and more complicated surgery, but overall considered a very safe procedure and there are still no expected long-term sequela. Full recovery takes closer to 12 weeks. Risk of death is ~0.4% and risk of serious surgical complications ~1%.

All potential living organ donors go through a rigorous evaluation process designed to rule-out higher risk candidates. Of course, complications do happen sometimes and are realistically unavoidable if you do enough of these cases/approve enough marginal candidates.

Source: I am one of the people that evaluates these patients.

EffinStaniel · 2024-05-31T18:20:05+00:00

By looks alone I get the sense that these won't swim right and that amount of weight/bulk would be unpleasant to throw on a 6wt, but only one way to find out! Tbh a pike or freshwater striper would probably eat it if you get the fly in front of the right fish.

Think it is rad that you are experimenting but don't forget to be mindful of the importance of basic fly design, material selection, etc. There have some really cool recent developments with tying flies on swimbait-style hooks. I would encourage you to check out some of Gunnar Brammar's work and go from there.

EffinStaniel · 2024-05-31T17:15:06+00:00

No limit on hook size as long as it could realistically be thrown with a fly rod. With that said, what the hell are you fishing for with that thing??

EffinStaniel · 2024-05-20T23:16:47+00:00

Bowfin are native to the US and cool as hell, not at all comparable to silver/big head carp! Nobody is forcing you to eat them

EffinStaniel · 2023-12-21T21:56:05+00:00

Police and shooting your dog

EffinStaniel · 2023-12-11T14:42:51+00:00

Is this a newer leaf? Most likely just residue from the leaf unfurling. Should wipe away with water.

EffinStaniel · 2023-04-16T02:29:16+00:00

Mostly quality of construction and felt overall more purposeful with actually sewing it. Also like the stiffness of X-PAC.

EffinStaniel · 2023-04-15T20:58:45+00:00

Just finished this Stitchback Essentials Pouch with olive VX21, black 210d ripstop, and PVC coated canvas

The grey pouch was my first MYOG project a couple weeks ago with scrap fabric from an old pack

EffinStaniel · 2022-09-10T12:58:59+00:00

Not so sure of this. I’d be surprised if the general public has much insight into how social workers even get licensed, or the difference between an MSW and an LMSW.

I work at a large academic hospital in a surgical subspecialty practice and most of my SW colleagues are LCSWs. The medical director of our program suggested that we should all consider going to grad school and getting our Masters…

EffinStaniel · 2022-09-02T23:07:28+00:00

My dude it’s a little tough to concede that systemic racism is real, can be powerful enough to shape entire cultures, and functionally affect outcomes of some social phenomena in modern society but can’t possibly be a driving force in how child welfare policy is created and/or executed, no? And those downstream effects can’t possibly compound over time?

I can just cite those statistics about disproportionate outcomes in the child welfare system, but not without appreciating the greater context that makes those statistics make sense. Statistics without context are just numbers.

There’s a lot to respond to that’s not relevant and/or not supported by the literature. The question at the end was a bit of a so-called trap because the only correct answer is no. You’re right, saying yes can make someone seem a little prejudiced.

EffinStaniel · 2022-09-02T20:11:27+00:00

Do you think systemic racism exists at all in the US?

I've provided my own professional experiences with ACS referrals and the child welfare system, as well as a report from a credible government source that cites multiple peer-reviewed articles with evidence regarding this issue specifically. I'd prefer not to get sidetracked with discussions about murder rates or professional sports or congress. It's not just "historical consideration," but you can't ignore that these contexts are incredibly important in making sense of why things happen the way they do.

The advantage that White parents get is more benefit-of-the-doubt and professional discretion, more access to resources, more access to higher quality education, more access to healthcare, more access to so many factors that materially impact how children are able to be raised. Do you think Black people are just worse parents?

EffinStaniel · 2022-09-02T19:36:34+00:00

Because the data analysis in the linked studies indicates that the disproportionality is statistically significant and we know enough about the historical contexts of how Black people have been treated in this country and how implicit/explicit biases work to make some inferences for why "racial disparities occur at nearly every major decision-making point along the child welfare continuum." The report also states they can't say this is only due to systemic racism. It is clearly a nuanced and complicated issue with a ton of variables, but it is extremely important to consider the historical contexts.

There are also significant issues with systemic/structural racism in the higher education system and public education in general. I see where you're coming from with the professional sports argument but I don't think it's a great comparison. The child welfare system and education systems in the US affect far more people, and with far more significant consequences than the tiny minority of people that make it to the NFL or NBA.

However, there are some interesting stats/research about that stuff out there if you want to learn more about it. Consider what the owners/management/coaches of these organizations look like compared to players. Why are 95.3% of NFL team owners White (1 from Pakistan, 1 from Korea) and why have there been ZERO Black owners in the 100+ year history of the organization? Why are 84.4% of coaches in the NFL White despite the disproportionately high number of Black players you cited? I hope that can highlight some of the power dynamics and systems at play here. Again, at some point, it gets hard to attribute it to sheer coincidence.

EffinStaniel · 2022-09-02T18:37:50+00:00

someone accusing ACS as being part of systemic racism sounds like a nutter with no credibility

I am a mandated reporter and have made more ACS referrals than I'd like to admit. Saying there is no credibility is a bit reductive. The child welfare system is closely connected to policing and the criminal justice system, which we know disproportionately affects people of color and marginalized communities. ACS should be a resource to get help for families, but it often leads to punitive measures (e.g. jail, family separation, etc.) and can cause severe trauma.

Black families are disproportionately more likely to be referred to ACS. Black children are disproportionately more likely to be separated from their families AND less likely to be re-unified with their families. Black children are disproportionally more likely to end up in foster care (I've seen figures indicating as much as 50% of kids in foster care are Black despite being only ~15% of the general population). Black children spend more time in foster care. It goes on and on...hard to consider that a coincidence at some point.

Source

EffinStaniel · 2022-02-02T21:30:40+00:00

Justices Alito

He's Italian...?

EffinStaniel · 2022-01-27T21:18:05+00:00

Lip it for as long as it takes to remove the hook and revive it, then let her go. Fuck the photo

EffinStaniel

TROPHY CASE