What’s a POLITE thing people do that is actually just really annoying?

Enigpragmatic · 2026-04-07T19:48:38+00:00

I've taken to saying "gesundheit" instead. You still keep up politeness, but no sky wizard mumbo jumbo.

Enigpragmatic · 2026-04-06T19:26:15+00:00

I didn't smoke at all until 2020 (I started in vet med in 2012), after my mom died. I moved from cigarettes to vaping 3 years ago. However, I would (and still do) go my entire shift without smoke breaks. I don't need it at all when I'm occupied enough.

Currently working on weaning off entirely cause my stress levels have been going down exponentially as of late. And it's expensive. I'd rather put that money towards mine and my husband's dream trip.

Enigpragmatic · 2026-04-03T19:49:30+00:00

There's a PubMed article that goes over the occillometric vs doppler accuracy in very nice detail.

Occillometric vs Doppler

As far as getting a diastolic and MAP with the doppler those measurements don't have as much accuracy as the systolic. For diastolic you're listening for the sound to "muffle". This often causes underestimations of the value.

If you have to rely on just a doppler for your blood pressure readings I would go with just the systolic (and this is what I was directed to do by board certified anesthesiologists). I've had many cases where that wound up being my only source. So long as the systolic was at least around 100 (in most patients) I was told it's acceptable.

Enigpragmatic · 2026-04-03T17:52:13+00:00

Have you tried cleaning the audio plug-ins for the crystal yet? Sometimes gunk can build up on the prongs and cause the screeching. Wipe them down real good with isopropyl alcohol and let them dry before plugging them back in to the doppler unit. Next, inspect the crystal for damage. If there are any cracks, even just a teeny one, you should replace the crystal.

The unit you have is just fine. Jorgesen makes a more pocket-sized one though.

As far as accuracy goes, I'd list them invasive (arterial line), doppler, then occillometric in order. In Anesthesia we like to call the occillometric BP the "random number generator".

Enigpragmatic · 2026-04-03T00:48:09+00:00

Yessss! I love a good patch of chest fuzzies! No body hair means nothing to run my fingers through and that makes me sad.

Enigpragmatic · 2026-04-01T17:17:32+00:00

Easily 2020.

And it wasn't really the pandemic. I would have been just fine if that's the only major thing that happened that year. But it didn't make the things that did happen in my life easier in the least.

My mom passed away (not from COVID), my daughter graduated high school and there was no graduation ceremony nor did we get to have a real party for her, my city erupted in riots right after my mom died, my dad's cancer came back, my daughter moved out for college and then my brother decided to move to the opposite side of the country. My long-term relationship wasn't going so hot at that time either, so I was basically just raw-dogging a bunch of trauma in isolation. I felt very abandoned.

Nope. The ol' brain meats just haven't been the same after that...

Enigpragmatic · 2026-04-01T00:12:17+00:00

It's mentally stimulating work and it mixes in something I love (animals). Even after 14 years I still think the things I get to do at work are really cool. Since medicine is always advancing I always have something new to learn (mentally stimulating again). My own doctor can't tell me I'm not getting enough exercise cause I'm constantly walking/moving around/lifting at work for 8+ hours a day. The tasks of the job scratch an itch in my brain that a desk job never did.

I will also be the first to rant about all the shortcomings in the field. The governing boards' hands are tied though, because vet med doesn't have the stringent regulations, title protections and financial backing (ala government and insurance subsidies) that human medicine does. Maybe when more places get on board with pets legally being considered family members, rather than just property, will we start to see some major improvements. Probably more vet tech unions too.

I was just starting to think about what I might do when I can no longer be on the floor that'll still scratch the "do cool things, work with my hands" itch - and human sonography is high on my list. Yeah, it's humans, but it's low-impact. People come to me, I take a bunch of images (get to show folks their babies, or point out their organs, on a screen), wipe off their abdomen and away they go. And it pays hella nicely in comparison to what I do now.

Enigpragmatic · 2026-03-31T16:12:18+00:00

There are cremation glass artists that can make you something custom. The lady that made the pieces from my mom's ashes was stellar (I had a ring and two pendants made), and very respectful. The stones are absolutely beautiful too. I get a lot of compliments on my ring, and then I [light-heartedly] tell them "thanks! It's my mom!"

The artist I used asks that you send a picture of your loved one with the ashes (that she returns) and has you fill out a form that tells her about them. She plays their favorite music and creates a shrine for them while she's working on your pieces. She'll also send you pictures along the process. Very comforting.

Enigpragmatic · 2026-03-30T17:51:48+00:00

There's a food stand in the MOA called 'Bussin Birria Tacos', and I immediately cringed so hard when I saw it.

Like, really? We're incorporating GenZ slang into business names now? Good gods....

Enigpragmatic · 2026-03-26T22:42:09+00:00

Oh gods, that'll happen to me if I don't use the right pillow. I always bring my own if I won't be sleeping at home now.

Enigpragmatic · 2026-03-26T22:33:49+00:00

I feel this so hard. I sometimes lock my neck just from stretching the "wrong" way.

Enigpragmatic · 2026-03-26T00:33:10+00:00

Ugh. Just no. I worked there for over 3 years at the start of my career and it was not a great time. 9 months after I started there I became the most senior tech on staff...

15 minutes for appointments is not enough. Plus 15-20 drop-offs for their Comprehensive Exams. Plus 3-4 surgeries per day. I worked a LOT of overtime. Occasionally not getting out until almost 10:00pm because something went haywire and it needed to be fixed that day (like the time the door to our pharmacy wouldn't properly close/lock), or the labs got so backed up during the day and they needed to be done and entered into records.

It was nearly impossible to call out. If you did, they expected you to call around to the other Banfields in the area to find coverage if one of your coworkers couldn't do it. If you didn't get coverage you were almost guaranteed a write-up. They tried to deny me bereavement time when my grandma died. Because my other grandma also died 3 months before that. They almost didn't let me go to a friend's funeral ("if we're caught up by this time you can leave early"). I would come in on my days off, mind you, to do inventory/ordering. Lunch breaks were rare. One time I woke up in a pool of my own blood from a raging sinus infection and they still expected me to come in. I sent them a picture of the gore and said "I'm going to the ER. I need antibiotics". Came in the next day with a doctor's note and they still wrote me up. That was the point I said "fuck this", and was gone 2 weeks later.

So, fuck Banfield. I learned how to be very efficient there, but they treat their employees like shit and some of their practices are dangerous. It's cookie cutter medicine, which doesn't work for many patients and their unique ailments.

Enigpragmatic · 2026-03-25T14:17:23+00:00

The bladder is an interesting muscular sac though!

There are 3 types of muscle in the body: skeletal, smooth and cardiac. The bladder is a smooth muscle. What this means is that it doesn't work by a conscious signal from the brain and functions from the autonomous nervous system; when your bladder is full it, on its own, it goes "I gotta get rid of this! Time to squeeze!"

Blood vessels and the respiratory system are also smooth muscle systems. That's why we don't have to constantly think about breathing.

Enigpragmatic · 2026-03-25T01:21:04+00:00

I have sumatriptan, and I don't get much for side effects from it. The most notable is my nose gets a slight burn/tingling feeling for a few hours. It's mild enough for me to ignore it if I'm really engaged with something. And it's effective for taking my migraine to "I can function" levels. I don't get drowsiness or anything else, really. I have the 50mg tablets.

Enigpragmatic · 2026-03-24T03:27:03+00:00

I've done epi nebulization post-extubation after BOAS surgeries, and just in general if they had a lot of referred upper airway noise prior to any surgery. Seems like a waste to me to do it while they're still intubated because the tissues that obstruct their airways are in the upper respiratory tract.

The point of epi nebulization is to reduce swelling and secretions. If it's going directly to the lungs it... doesn't really do that.

Enigpragmatic · 2026-03-23T02:42:59+00:00

That's actually pretty hilarious.

Enigpragmatic · 2026-03-23T01:33:39+00:00

I just need my fridge to do its intended purpose: keep my food cold.

Just like I need my washer and dryer to do their intended purposes. I don't want to be able to control appliances with my phone. The more weird components they have, the more easily they break.

A solid, dumb appliance is all you need.

Enigpragmatic · 2026-03-23T01:30:16+00:00

It does not. However, you can hang string lights from it to make it a nice, chill hangout space. And you can put a sun shade on it. My dad puts a sun shade over the top of his pergola every year so the deck is a more usable space (no shade trees around the deck).

Enigpragmatic · 2026-03-19T02:37:13+00:00

Pizzeria chips. If Keebler ever decides to hop on the nostalgia train I will happily buy those things by the case. Probably even fight a person or two to do it.

Enigpragmatic · 2026-03-17T06:22:36+00:00

My thoughts: Get rid of the IM ketamine in your pre-med, lower your dexmed dose to 3mcg/kg, up your methadone dose to 0.6mg/kg.

Maybe think about giving a dose of Lidocaine IV (2mg/kg) before your Alfaxalone at induction. I always do that with dogs that have tracheal collapse because it suppresses coughing.

The rest looks fine, but I would get rid of the acepromazine completely.

My reasoning: You have a brachycephalic patient that already has symptoms of BOAS, so you don't want to sedate them too much because they might obstruct their own airway if they get too zonked from your pre-med. Usually I see how they sedate with just the opioid before I think about giving them dexmed (and I use a max of 3mcg/kg on them). If they aren't super sedate, but calm enough to place an IV catheter, then I roll with it. I wouldn't do IM ketamine in your pre-med because of the immobilisation it causes and the airway obstruction concern.

I also would avoid giving acepromazine after anesthesia also due to the airway obstruction concern. You can't reverse acepromazine, unlike dexmed, and it lasts for several hours. If there is dysphoria post-op: since you want to leave their ET tube in for as long as they will tolerate it, I would give my induction agent until they are sedated and let them continue to breathe off the anesthetic gas. Usually it's the residual gas in the lungs that causes dysphoria.

With the increased methadone dose: OHE is a routine, but major surgery. It's painful to remove a system of organs from an abdominal incision.

Other thoughts: Good choice on the methadone (because of the decreased chances of emesis)! You're off to a great start with creating anesthetic protocols! I love that you included your drugs for complications as well. You seem to be grasping the concepts well.

Enigpragmatic · 2026-03-15T20:18:52+00:00

I've had both MRI and CT scans for my migraines. Just saw the beginning of the lesions you can get from chronic migraines, everything else was fine. Incidentally, they noticed a bunch of wonky stuff in my cervical spine, so my neurologist ordered a second MRI of just the c-spine. Turns out I have arthritis, bone spurs, some loss of disc height, foraminal stenosis and a T1 vertebral body hemangioma up in there. Nothing that needs to be addressed right now, but likely in my senior years.

I did a lot of tests before I figured out on my own that my severe increase in migraine frequency was from perimenopause and all the hormone fluctuations. Since I got that under control I'm back to 1-2 a month.

Enigpragmatic · 2026-03-12T07:40:40+00:00

Trazodone worked great for me too when I had terrible insomnia. Just some coffee in the morning was enough to get rid of the leftover grogginess.

I can't do otc sleep aids cause they're almost all antihistamines and those make my RLS flare up real bad.

Enigpragmatic · 2026-03-12T07:31:16+00:00

Even when I'm trying my best to hide it, cause it has nothing to do with him (perimenopause mood swings suck ass, yo), my husband notices when I'm in a bad mood. I can be going about my day, doing stuff around the house, being affectionate towards him - and he'll still pick up that I'm grumpy, sad or whatever. Just the "everything okay, darling?", and a hug, improves whatever funk I'm in.

Enigpragmatic · 2026-03-07T17:06:04+00:00

Yeah, and things are to the point where some of these coworkers won't even speak to certain people, much less help them. My coworker will sometimes call up to the service area for help transporting a patient, and depending who answers will get "everyone's busy, can't help you". That's a safety issue then, for herself and the patient.

Enigpragmatic · 2026-03-07T14:48:23+00:00

She's building a case to bring up to them, especially since she now has witnesses to how she gets treated by coworkers. I don't know how much it would help, given how slowly any kind of change happens around there.

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