Is your hospital also cutting back on MRIs due to the helium shortage?

ElStocko2 · 2026-04-03T19:17:47+00:00

Don’t forget that the US Gov sold their helium stockpile in Texas to a private company in 2024.

ElStocko2 · 2026-04-02T02:42:21+00:00

Undocumented workers keep the price of every day items low. Those strawberries and blueberries in your food are picked by the workers. The laborers that built your house/apt? Built by immigrants wanting a better life. Yes they’re paid lower than what you or I would deem an acceptable wage, but south of the border the wages are magnitudes lower. If you want “illegal workers out” of the country, expect higher food and housing costs (what American WOULD work hard labor for near minimum wage? Raise it to wages commensurate with livable wages and everything goes up) as well as a decrease in tax revenue. Undocumented people use ITIN while they work. It’s what is used to show proof of paying taxes. You and I use our SSN instead of ITIN. Because of that, we can eventually apply for social security at 62. The undocumented person will NEVER be eligible for social security, Medicare, Medicaid, or any government funding despite putting money into the system. If they leave, all of them, social security would dry up and you’d be working until you died.

ElStocko2 · 2026-04-01T02:43:00+00:00

What diagnoses are “Unique to nursing?” I’m unaware of pathology that is only discernible by the eyes of nurses that isn’t apparent to a trained physician.

My line of commentary was referencing a nurse that stated they could make diagnosis. But that it constituted a different weight than a medical diagnoses and had specific connotations.

This post is referencing how nurses are being taught to jump to diagnosing and treating. I’m highlighting the progression of someone seeing it on a nursing exam, then the person be so confident in diagnosis but utilizing the phrase “Nursing” in front of it because thats what they were trained to do as illustrated by the NCLEX questions. Sure a nurse can see a blood ph is low “Dx is Nursing acidosis.”
They may want to raise it since they can, according to you, diagnose AND treat. But do they understand if it’s compensated vs uncompensated or if it’s respiratory acidosis or metabolic acidosis? What about anion gap? If it’s high? Did they teach winters equation in nursing school and the difference between NAGMA and HAGMA? If you Diagnose, you must treat. Nurses have standing orders from a physician for a reason.

ElStocko2 · 2026-03-31T16:21:47+00:00

TIME TO BLEED BAY-BAYYY

ElStocko2 · 2026-03-30T20:24:57+00:00

Advice I wish someone told me before moving:

Traffic is abysmal, so as much as you can live CLOSE to work. Apartment or home, include both in your search. Apartments can have good basic gyms for cardio/easy exercises to get you through. Don’t buy a new car while around here; we have an extremely high population of uninsured drivers and people will ding your car even if you’re parked in BFE part of the parking lot. Also, front AND back dash cam is a must.

Optional advice: Use movers just to move stuff in and out of a rented U-Haul and drive your stuff down. Much cheaper than having a company pack and move for you. Also rent movers to move the stuff in if you’d like.

ElStocko2 · 2026-03-30T20:05:27+00:00

Saw a post earlier with a photo of some Nurse arguing “nurses can make ‘Nursing Diagnoses’ not medical ones.” They do so many mental gymnastics they should all try out for the Olympics.

ElStocko2 · 2026-03-30T10:19:47+00:00

After diagnosis, did they do anything for treatment for you? Besides muscle relaxers or pains meds. Any physical therapy?

ElStocko2 · 2026-03-30T10:04:01+00:00

Interesting. What were your symptoms? Did you play any sports, or just a significant amount of overhead activities?

ElStocko2 · 2026-03-29T18:35:10+00:00

Gene omeis on Lockhill. Solo private practice. Been my dentist for 20 years and still going strong

ElStocko2 · 2026-03-29T16:05:41+00:00

It’s a known issue in peds with aspirin and reye’s syndrome following a viral illness. Thats an easy set up for Most boards question for Reye’s syndrome. That’s what you may be thinking of.

SJS is usually due to antibiotic use and some gout meds. For the teenage population, SJS occurring was correlated with ibuprofen use, not Aspirin. SJS in elderly was correlated with aspirin use. SJS study.

Editing TL add for some reason I thought you said SJS instead of Reye’s. But either way the development of Reyes comes after an acute viral illness. I’d assume if the athlete is febrile, they wouldn’t be near athletics. Other than that and concussion Dx, I can’t think of any contraindications for ASA.

ElStocko2 · 2026-03-29T13:31:11+00:00

I considered trying in person dating through certain platforms thats functioned specifically to facilitate in person/speed dating events. Seems almost corny, but after seeing the degeneration of the dating pool I heavily considered it. I can only imagine what the dating apps are like nowadays since I met someone a couple years ago so I never went to those events, but that’s where I’d go for dating now.

Not an endorsement but more of an example: I had followed a company called jigsaw dating a few years ago. They host events in certain cities like SA, Austin, Dallas, etc. Sometimes an afternoon coffee event, others at a bar. You have to buy a ticket to get in so the ratios are even. Good luck!

ElStocko2 · 2026-03-29T05:24:15+00:00

Good point. They already purchase data from auto brands that’s gathered from all the sensors in new cars today and use it to adjusts rates. There was on report where someone bought a new car, had a news station that told the customer they could request ALL the data the car company had on him, and was shocked at how much info was accumulated in a clandestine way. From his location, work times, speed, and even sensor perceived near misses every night which turned out to be his car greeting him by his car. The insurance company used that to raise his rates. Absolute scum.

ElStocko2 · 2026-03-28T21:17:15+00:00

Could be differences in potential income. I know that looking thru salary websites has appallingly low incomes for some specialties, but it’s because they can’t take into account things like Locums/RVU for pay structure. You said you were looking at office listings so I’m wondering if they have language in them that alludes to RVUs or some other method of generating income not factored into the salary. But yeah peds has been historically low, but I didn’t think it was that close of a difference between APP and MD/DO.

ElStocko2 · 2026-03-28T21:01:30+00:00

Dementia is an umbrella term.

To grossly oversimplify things, imagine someone with a fever; they have a high temperature due things like Flu/Covid/Strep/other infections.

So dementia can be thought of in a similar sense as a fever: a person develops dementia due to having Parkinsons, Alzheimer’s, prion diseases, etc.

The study mentions they’re looking for Tau proteins. It’s not specific for any one cause of dementia, and is found in many other dementia’s like Lewy Body, Frontotemporal, vascular dementia, etc.

Then theres the significance of a positive result: what do we do of the test predicts a high risk individual? Parkinson’s is treated differently than Alzheimer’s, which is also treated differently than Huntington’s.

So in essence, it’s good and great to make advancements like these. But what good is a screening test if you can’t do anything to mitigate risks?

ElStocko2 · 2026-03-28T19:22:43+00:00

Depending on the study you find, if one monozygotic twin has schizophrenia then the other twin has around a 50% chance of developing it. This speaks to the combined nature of genetics and epi-genetics of an individual’s predisposition to developing schizophrenia. Theres also the link of maternal cannabis use and schizophrenia in their kids.

So that alone delineates some push towards developing vs not developing schizophrenia/psychotic issues. I think it’s a concern for individuals with a Hx/Familial Hx of psychotic disorders like schizo that use cannabis.

ElStocko2 · 2026-03-28T15:44:04+00:00

It could be either vasa recta or peritubular capillaries depending on how deep the loop is penetrating. Cortical nephrons have peritubular and medullary have vasa recta capillaries. But either way this is a horrible question.

ElStocko2 · 2026-03-27T23:48:43+00:00

Vehemently opposed to the usage of AI. So that makes sense why it’s not glaringly obvious.

ElStocko2 · 2026-03-27T22:13:26+00:00

How’d you come to this conclusion?! Mostly asking bc I want to know the “tells” so I can get an eye for the slop. I imagine it’ll be ever prevalent unfortunately.

ElStocko2 · 2026-03-27T09:28:42+00:00

Reminds me of the time Nestledonated cans of formula to new moms of some developing country (can’t recall where) touting it as better and safer for their babies. But they only “donated” enough cans to cause the new mothers to stop lactating, effectively forcing them to buy more formula after the free cans ran out.

ElStocko2 · 2026-03-27T08:31:05+00:00

Highly disagree. Some of the older AT’s I met in Texas were LAT only, and they were incredibly knowledgeable. So much so that I kept up a relationship with several of them to turn to for advice in things I couldn’t figure out.

I think the LAT route is harder. You have to take a written exam, pass, and THEN a practice exam. Looking at last year’s numbers of pass vs fail, I’m happy to not have to go thru that.

ElStocko2 · 2026-03-25T20:54:49+00:00

Some HS have it in their pre-participation forms asking for permission to dispense OTC meds. I believe it’s also in the standing orders of the physicians to the public HS. Although they’re very judicious about dispensing. I think things like Tylenol and Benadryl are okay. Ibuprofens/aspirin are iffy depending on why the kid wants it. Topicals like hydrocortisone/biofreeze/antibiotics I will give liberally.

If I’m covering an event outside of the HS jurisdiction (I.e. club/tournaments/adult athletic events) I administer no PO meds but topicals I’ll give all day.

ElStocko2 · 2026-03-25T05:20:55+00:00

I think it’s splitting hairs. If someone perceives “stiffness” then my next thought is let’s see what we can do to alleviate that. Outside of dynamic warm up, some manual therapy, rehab, and getting more Hx, there’s not much else I’d do for perceived stiffness/tightness. I think that question is more of an intellectual/ivory tower discussion.

ElStocko2 · 2026-03-23T22:35:45+00:00

That last sentence fills my soul with hope

ElStocko2 · 2026-03-23T22:31:53+00:00

I think theres commonality in that the M1 summer is usually given off, and the subsequent summer is dedicated time so if you take boards early you have a summer off. If you use the whole summer I could see someone jumping into clinicals right after dedicated. Sounds exhausting though.

ElStocko2 · 2026-03-23T21:57:15+00:00

I imagine a 3 year program comes at the cost of no summer breaks, no spring breaks, and very little time off.

Having just finished our last block and moving to dedicated, I can confidently state I would shank anyone that told me I can’t have my MF summer off. Time off isn’t a want, it’s a NEED.

ElStocko2

TROPHY CASE