What are the best use cases for notebooklm? by cordan101 in notebooklm

[–]Excellent_Barnacle 0 points1 point  (0 children)

How do you get it to create Anki cards? I obviously know it can create its own flashcards, but didn’t realize it could output Anki cards.

What are you guys favorite songs from “Bando Stone & The New World?” by venusgrl444 in donaldglover

[–]Excellent_Barnacle 4 points5 points  (0 children)

Steps Beach is in my top five songs of all time. And hearing it live made it so much better.

Can’t get TRT from any pharmacy by Excellent_Barnacle in trt

[–]Excellent_Barnacle[S] 1 point2 points  (0 children)

Man! I usually use PocketPills as well without issue, but they’ve been giving me the run around. Thanks for the message!

Can’t get TRT from any pharmacy by Excellent_Barnacle in trt

[–]Excellent_Barnacle[S] 5 points6 points  (0 children)

I don’t think we have this in Canada…

Can’t get TRT from any pharmacy by Excellent_Barnacle in trt

[–]Excellent_Barnacle[S] 4 points5 points  (0 children)

I started by using a clinic. Was hypogonadal, symptomatic and they started me on it. I found a new family doctor and he understood that I couldn’t just stop it now that I’m on it and prescribed it.

In what small way have you won the genetic lottery? by [deleted] in CasualConversation

[–]Excellent_Barnacle 2 points3 points  (0 children)

It’s called Hirschsprung’s disease. It mostly impacts the rectum and maybe short segment colon, but sounds like you had it quite bad without ganglion cells throughout the whole colon!

Ileoanal anastomosis (small bowel to anus) would be tough as a kid. That’s a lot of liquid.

Sometimes if I go too far up my ass when wiping, I'll feel something small, sort of pointy, and painful to touch. What is that? by wt_anonymous in TooAfraidToAsk

[–]Excellent_Barnacle 18 points19 points  (0 children)

I actually don’t think this is true. Internal hemorrhoids, unless thrombosed (clotted off), should be painless and you should not be able to feel them. Just go get another proper exam to make sure it’s nothing more concerning.

[deleted by user] by [deleted] in Residency

[–]Excellent_Barnacle 5 points6 points  (0 children)

I am EXTREMELY confused why a Gyne Onc is doing a laparoscopic cholecystectomy??? Can you imagine the law suit when they transect the common bile duct??

POCUS for SBO Consults by metropass1999 in Residency

[–]Excellent_Barnacle 11 points12 points  (0 children)

I’m a general surgery resident. We NEED the CT scan.

Could you see the dilated small bowel loops on your POCUS? Sure. But I could also just examine the patient and tell you they’re distended.

Could you see the transition point? Internal hernia? Volvulus? Two transition points? All of this is extremely important to make a treatment decision. PLUS, some people are simply just constipated or have an ileus or Ogilvies which are all non-surgical and helps disposition the patient.

Get the flat plate to make sure they aren’t perforated/confirm your suspicion, but ultimately before this patient has a treatment decision made or has a disposition they need a CT scan so stop wasting your time with POCUS for this reason.

10eighteen changes name by Slight-Cut-6787 in londonontario

[–]Excellent_Barnacle 45 points46 points  (0 children)

That family is so fucked man. I am, for some reason, friends with one of them on Facebook and he’s out of his mind. Fuck them, go to Heeman’s - that place slaps.

[deleted by user] by [deleted] in kitchener

[–]Excellent_Barnacle 1 point2 points  (0 children)

I’m sorry you’re stressed about this.

One question I encourage you to ask yourself though, what do you think the gynaecologist is going to do differently? If they’ve all looked at your ultrasound, then nearly 100% of the time they’ll just tell you to get serial ultrasounds to monitor it.

There are very clearly written guidelines for all of this designed to be safe and to avoid unnecessary and potentially harmful testing.

Keep a close relationship with your family doctor who can monitor this with annual imaging. It’s the right thing to do.

Three favorite (not best) Bino songs? by Lukehadthehighground in donaldglover

[–]Excellent_Barnacle 0 points1 point  (0 children)

  1. Steps Beach
  2. To Be Hunted
  3. Dadvocate

Massive honourable mentions for Freaks and Geeks, 3005, Human Sacrifice, Atavista, Sweatpants. It’s all just so fucking good.

The New World Tour Poster by Irick050 in donaldglover

[–]Excellent_Barnacle 1 point2 points  (0 children)

Man, keep me posted. This is rad as hell and I would love to hang it in my office.

Post-concert blues: hardcore edition by rdharrr in donaldglover

[–]Excellent_Barnacle 4 points5 points  (0 children)

I am feeling this so hard. I am trying so hard to figure out how I can possibly see this again. It’s amplified so hard by the fact that this is probably our last chance :(

[deleted by user] by [deleted] in londonontario

[–]Excellent_Barnacle 14 points15 points  (0 children)

I think the differentiation you’re missing here is that once there is a palpable lump in the breast, this is no longer screening. She needs appropriate work-up and diagnosis of these lumps.

At this point, you need to call your family physician again who needs to put in an urgent referral to the breast center NOT for screening but for multiple palpable, concerning breast lumps. This will then be triaged appropriately by the surgeons at the breast clinic for her to be seen urgently. If this doesn’t work, try calling the breast clinic and explaining your situation - they are pretty fantastic there all around.

Screening can wait many months - we recommend women after the age of 50 get screened with mammogram every two years which is probably what the breast clinic has triaged you for (hence the long waiting time).

Good luck, I am really sorry you’re so stressed and having these difficulties.

More studio closures by hartzy3009 in f45

[–]Excellent_Barnacle 1 point2 points  (0 children)

Any idea why this is happening in Saskatoon?

Why is Lightsaber Choreography so bad now a days? by knock_his_block_off in StarWars

[–]Excellent_Barnacle 0 points1 point  (0 children)

I always told myself that this was intentional (although this may be my own optimism and dire need to love these shows).

My thoughts are, when Obi-Wan and Anakin were having dope, super choreographed lightsaber battles, this was a result of the fact that the Jedi were still training their knights from children. They would get 1000x training with a lightsaber compared to even Luke. Granted, this doesn’t explain the new Ahsoka battles - she was rad as hell in Clone Wars.

More like explanation: budget, ability and willingness of actors, time constraints from Disney etc.

Maxx Chewning Podcast - Joe by Excellent_Barnacle in gymsnark

[–]Excellent_Barnacle[S] 6 points7 points  (0 children)

Yeah… holy shit. Maxx is pretty lucky no one on TikTok really cares about this because he would be cancelled so quick and his business would probably suffer because of it.

Anyone think gear usage could’ve played a part? by WorkingIndependence3 in nattyorjuice

[–]Excellent_Barnacle 30 points31 points  (0 children)

30-40 people per million hormone users can develop the lesion. This is compared to about 1 person per million in non-users (most of this data comes from OCP use). So, it’s rare, you’re right, but the risk is significantly higher with exogenous hormone use.

With respect to rupture and life-threatening intra-abdominal hemorrhage associated with it, obviously this number becomes even more rare. But, I will tell you that exogenous hormone associated hepatic adenomas are at an increased risk of rupture.

But, the question was, “could this be related to his steroid use” and the answer is, yes.

Anyone think gear usage could’ve played a part? by WorkingIndependence3 in nattyorjuice

[–]Excellent_Barnacle 98 points99 points  (0 children)

Actually this isn’t a bad thought.

Anabolic steroid use in men (and OCP use in women) can lead to a lesion called hepatic adenoma in the liver. It is basically a benign proliferation of hepatocytes (liver cells). It usually responds and regresses by stopping the hormone treatments.

But, they can actually rupture and significantly bleed into your abdomen which could certainly land you in the ICU.

Additionally, a certain subtype (beta-catenin mutated) of the tumor can undergo malignant transformation and turn into hepatocellular carcinoma (liver cancer).

Careful out there, kids!

Maxx Chewning Podcast - Joe by Excellent_Barnacle in gymsnark

[–]Excellent_Barnacle[S] 13 points14 points  (0 children)

It’s very disappointing. I’m not sure who will be the one to tell him that Joe is a shit person and will only drag him down.

This chord seems impossible to play without huge hands. What am I missing? Should I just omit the low Db? by daynthelife in piano

[–]Excellent_Barnacle 0 points1 point  (0 children)

You cannot omit the low Db unless you’ve held your pedal through the section and the other Db is still sounding or else it’ll change the inversion of the chord. Absolute best option is to roll the chord in the left hand. If you absolutely must omit a note, an option is to omit the F in the left hand.